Australian Academic Misconceptions: Alcoholics Anonymous
A discussion paper concerning inaccurate references made in documents prepared for the Australian Government Department of Health and Ageing, including:
Guidelines for the Treatments of Alcohol Problems (2009)
The Treatment of Alcohol Problems, A Review of the Evidence (2009)
Prepared by a 17 year veteran AA member and historian
18 April 2013
Guidelines for the Treatments of Alcohol Problems (2009)
The Treatment of Alcohol Problems, A Review of the Evidence (2009)
Prepared by a 17 year veteran AA member and historian
18 April 2013
1. Introduction
2. “Australia’s most widely available program for alcohol-dependent people.”
3. AA and religion
4. The 12 Steps
5. AA’s main program texts: background
6. Indoctrination of AA newcomers
7. AA’s working model of alcoholism
8. Studies and statistics: re-evaluation of comparisons
9. Common misperceptions of AA’s benignity
10. Bureaucratic buck-passing and patient coercion
11. References
2. “Australia’s most widely available program for alcohol-dependent people.”
3. AA and religion
4. The 12 Steps
5. AA’s main program texts: background
6. Indoctrination of AA newcomers
7. AA’s working model of alcoholism
8. Studies and statistics: re-evaluation of comparisons
9. Common misperceptions of AA’s benignity
10. Bureaucratic buck-passing and patient coercion
11. References
Introduction
Guidelines 2009 mentions that patients demonstrating higher levels of symptom severity are more likely to affiliate with AA, a view supported by this paper, which aims to:
· Raise awareness on contemporary AA culture and history, compared with what little is offered by AA’s superficial PR to professionals.
· Explore aspects of AA that Guidelines doesn’t, including detrimental iatrogenic effects on those less likely to affiliate with AA.
· Demonstrate unsuitability of Intensive AA Referral for some.
· Address the Guidelines 2009 interpretation of AA’s Steps and its denial of members’ required religiosity to benefit from the program.
The author does not write on behalf of AA and is not affiliated with any other alcohol recovery organisation.
.
Guidelines 2009 mentions that patients demonstrating higher levels of symptom severity are more likely to affiliate with AA, a view supported by this paper, which aims to:
· Raise awareness on contemporary AA culture and history, compared with what little is offered by AA’s superficial PR to professionals.
· Explore aspects of AA that Guidelines doesn’t, including detrimental iatrogenic effects on those less likely to affiliate with AA.
· Demonstrate unsuitability of Intensive AA Referral for some.
· Address the Guidelines 2009 interpretation of AA’s Steps and its denial of members’ required religiosity to benefit from the program.
The author does not write on behalf of AA and is not affiliated with any other alcohol recovery organisation.
.
Buddha, 6th century BC: “Do not believe in anything simply because you have heard it. Do not believe in traditions because they have been handed down for many generations. Do not believe anything because it is spoken and rumored by many.” (Kalama Sutra.)
The most widely available program for alcohol-dependent people in Australia
More than three and a half million Australians will experience problems of alcohol abuse and dependence during their lifetime but only one in five of these seeks treatment. So found a 2010 study, providing the first ever lifetime estimates of alcohol problems in Australia. The report, analysing data from the 2007 National Survey of Mental Health and Wellbeing (AIHW, 2008) and published online in the journal Addiction, was launched at the National Drug and Alcohol Research Centre’s 2010 Annual Symposium.
The report also found, “Disturbingly 42 per cent of Australians with alcohol problems have at least one co-existing mental illness, such as depression or an anxiety disorder. Yet while close to half of all Australians suffering from depression are being treated, only 22 per cent of people with alcohol related problems receive help.” NDARC’s Professor Maree Teesson commented at the report’s release, “One reason for the lack of treatment is that alcohol problems still have a terrible stigma about them.” Professor Paul Haber, Medical Director Drug Health Services for Sydney South West Area Health Service, added that treatment for alcohol problems is generally not readily available to people and requires more funding. “There is evidence that treatment for alcohol disorders is effective but people are either not confident in the treatment that exists or they simply don’t know where, how and when to access it,” he said. (NDARC, 2010.)
Why might 21st century Australians feel stigmatised about such a long-established globally-recognised, treatable condition (“respectable” compared with illicit drug addiction), and what is it about Australia’s alcohol disorder treatment options that they lack confidence in?
The above quoted Professor Haber is also one of a team of four authors of the Federal Government’s Guidelines for the Treatments of Alcohol Problems 2009, which correctly acknowledges Alcoholics Anonymous as “the most widely available program for alcohol-dependent people in Australia” (Haber et al, 2009). AA is not the only self-help option outlined in the guidelines, which also include the evidence-based alternative, SMART Recovery. The authors also acknowledge that AA is not intrinsically a form of treatment and that patients demonstrating higher levels of symptom severity are more likely to affiliate with AA – two succinct points at odds with AA’s ‘mainstay’ status and related professional perpetuation of AA as a favoured one-size-fits-all referral choice.
Medical training may touch briefly on the workings of AA. Practitioners may, at some point in their professional journeys, have sought out and thoroughly studied the working program texts, though it is unlikely that they would have read more than the AA Preamble, its listed Twelve Steps of recovery and its To The Professional pamphlets. Many, therefore, unless AA members themselves or related in some way to one, are only sparsely knowledgeable as to AA’s user-level modus operandi. So how, logically, can Australia’s health professionals offer adequately informed recommendation and advice in guiding a client towards AA as a suitable choice of plan?
Eager professionals may check the government guidelines. The more thorough might check The Treatment of Alcohol Problems, A Review of the Evidence (Proude, et al), again by Professor Haber and his same co-authors of the Guidelines for the Treatments of Alcohol Problems 2009. This does note that one Cochrane review comparing AA and other 12-step programs to other psychosocial interventions (Ferri, et al) found that no experimental studies unequivocally demonstrated the effectiveness of AA or Twelve Step Facilitation approaches to reduce alcohol dependence or problems.
So, these two Australian documents do provide a balanced overview. Yet to those with more direct AA involvement, both documents become conspicuously misinformed and misinforming, by claiming, “A common misconception concerning 12 step groups is that members need to be religious to benefit from the program.”
The Review of the Evidence backs this misguided claim by citing the 1999 Winzelberg and Humphreys study, describing it thus: “In a study of 3,018 male substance abusers, individuals involved with AA demonstrated improved outcomes whether or not they identified with a particular religious or spiritual belief system.” Firstly, “whether or not they identified with a particular religious or spiritual belief system” does not translate as “whether or not they were religious”. Furthermore, that study’s weightier positive findings concerned effectiveness of referral, which resulted only in increased meeting attendance. It was only 12-step participation that resulted in improved alcohol outcomes. To reiterate precisely - the abstract says [my emphasis added]: “Referrals to 12-step groups were effective at increasing meeting attendance, irrespective of patients' religious background, and all experienced significantly better substance abuse outcomes when they participated in 12-step groups.”
That abstract says, specifically: “Many addiction professionals have reservations about referring nonreligious patients to 12-step groups” (and rightly so), semi-concluding, ambiguously, “The viewpoint that less religious patients are unlikely to attend or benefit from 12-step groups may therefore be overstated” [my emphasis added].
It does NOT say that members don’t need to be religious to benefit from AA meeting attendance – study participants only benefited from meeting attendance if they participated (in a religious program, which requires conversion to religious belief).
Choice of paraphrasing in Guidelines for the Treatments of Alcohol Problems 2009 and Review of the Evidence has reinterpreted by failing to distinguish between "attendance" and "participation" and between "religious background" and "religiosity". Such imprecision may be excusable from a purely observational perspective, but has significant implication in the context of recommendation for 'Intensive Referral' which is what the documents advocate.
Both documents further downplay AA's religiosity by advising, “It is important to note that the concept of God or a ‘higher power’ includes anything of a transpersonal nature that can be drawn on for strength, including the AA group” (a moot point, as any higher power of a transpersonal nature is religious in 12-step workings). Cited as reference for this are the two Browne studies, The selective adaptation of the Alcoholics Anonymous program by Gamblers Anonymous (1991) and Really not God: Secularization and pragmatism in Gamblers Anonymous (1994). Obviously, no AA group, Big Book study meeting or Steps meeting uses GA’s adaptation of its program. Though also 12-step, GA has a significantly different culture to AA, with 12 different, less religious steps - only 2 direct mentions of God - and is not anchored to AA’s 2 über religious main program texts. AA’s 12 Steps contain six references to God, eight of the 12 religious by nature. AA’s culture is steeped in its own deeply religious roots, history and related internal folklore. Members face religious peer pressure, discouragement from using the group as a higher power and legitimate reasons not to. AA’s main working texts specifically state, on the point of concepts of higher power, e.g. "From great numbers of such experiences, we could predict that the doubter ... would presently love God and call Him by name." (Twelve Steps and Twelve Traditions, page 109.)
The downplaying of AA’s religiosity in Guidelines for the Treatments of Alcohol Problems 2009 and Review of the Evidence is not the reality incoming or continuing AA members will encounter.
The most widely available program for alcohol-dependent people in Australia
More than three and a half million Australians will experience problems of alcohol abuse and dependence during their lifetime but only one in five of these seeks treatment. So found a 2010 study, providing the first ever lifetime estimates of alcohol problems in Australia. The report, analysing data from the 2007 National Survey of Mental Health and Wellbeing (AIHW, 2008) and published online in the journal Addiction, was launched at the National Drug and Alcohol Research Centre’s 2010 Annual Symposium.
The report also found, “Disturbingly 42 per cent of Australians with alcohol problems have at least one co-existing mental illness, such as depression or an anxiety disorder. Yet while close to half of all Australians suffering from depression are being treated, only 22 per cent of people with alcohol related problems receive help.” NDARC’s Professor Maree Teesson commented at the report’s release, “One reason for the lack of treatment is that alcohol problems still have a terrible stigma about them.” Professor Paul Haber, Medical Director Drug Health Services for Sydney South West Area Health Service, added that treatment for alcohol problems is generally not readily available to people and requires more funding. “There is evidence that treatment for alcohol disorders is effective but people are either not confident in the treatment that exists or they simply don’t know where, how and when to access it,” he said. (NDARC, 2010.)
Why might 21st century Australians feel stigmatised about such a long-established globally-recognised, treatable condition (“respectable” compared with illicit drug addiction), and what is it about Australia’s alcohol disorder treatment options that they lack confidence in?
The above quoted Professor Haber is also one of a team of four authors of the Federal Government’s Guidelines for the Treatments of Alcohol Problems 2009, which correctly acknowledges Alcoholics Anonymous as “the most widely available program for alcohol-dependent people in Australia” (Haber et al, 2009). AA is not the only self-help option outlined in the guidelines, which also include the evidence-based alternative, SMART Recovery. The authors also acknowledge that AA is not intrinsically a form of treatment and that patients demonstrating higher levels of symptom severity are more likely to affiliate with AA – two succinct points at odds with AA’s ‘mainstay’ status and related professional perpetuation of AA as a favoured one-size-fits-all referral choice.
Medical training may touch briefly on the workings of AA. Practitioners may, at some point in their professional journeys, have sought out and thoroughly studied the working program texts, though it is unlikely that they would have read more than the AA Preamble, its listed Twelve Steps of recovery and its To The Professional pamphlets. Many, therefore, unless AA members themselves or related in some way to one, are only sparsely knowledgeable as to AA’s user-level modus operandi. So how, logically, can Australia’s health professionals offer adequately informed recommendation and advice in guiding a client towards AA as a suitable choice of plan?
Eager professionals may check the government guidelines. The more thorough might check The Treatment of Alcohol Problems, A Review of the Evidence (Proude, et al), again by Professor Haber and his same co-authors of the Guidelines for the Treatments of Alcohol Problems 2009. This does note that one Cochrane review comparing AA and other 12-step programs to other psychosocial interventions (Ferri, et al) found that no experimental studies unequivocally demonstrated the effectiveness of AA or Twelve Step Facilitation approaches to reduce alcohol dependence or problems.
So, these two Australian documents do provide a balanced overview. Yet to those with more direct AA involvement, both documents become conspicuously misinformed and misinforming, by claiming, “A common misconception concerning 12 step groups is that members need to be religious to benefit from the program.”
The Review of the Evidence backs this misguided claim by citing the 1999 Winzelberg and Humphreys study, describing it thus: “In a study of 3,018 male substance abusers, individuals involved with AA demonstrated improved outcomes whether or not they identified with a particular religious or spiritual belief system.” Firstly, “whether or not they identified with a particular religious or spiritual belief system” does not translate as “whether or not they were religious”. Furthermore, that study’s weightier positive findings concerned effectiveness of referral, which resulted only in increased meeting attendance. It was only 12-step participation that resulted in improved alcohol outcomes. To reiterate precisely - the abstract says [my emphasis added]: “Referrals to 12-step groups were effective at increasing meeting attendance, irrespective of patients' religious background, and all experienced significantly better substance abuse outcomes when they participated in 12-step groups.”
That abstract says, specifically: “Many addiction professionals have reservations about referring nonreligious patients to 12-step groups” (and rightly so), semi-concluding, ambiguously, “The viewpoint that less religious patients are unlikely to attend or benefit from 12-step groups may therefore be overstated” [my emphasis added].
It does NOT say that members don’t need to be religious to benefit from AA meeting attendance – study participants only benefited from meeting attendance if they participated (in a religious program, which requires conversion to religious belief).
Choice of paraphrasing in Guidelines for the Treatments of Alcohol Problems 2009 and Review of the Evidence has reinterpreted by failing to distinguish between "attendance" and "participation" and between "religious background" and "religiosity". Such imprecision may be excusable from a purely observational perspective, but has significant implication in the context of recommendation for 'Intensive Referral' which is what the documents advocate.
Both documents further downplay AA's religiosity by advising, “It is important to note that the concept of God or a ‘higher power’ includes anything of a transpersonal nature that can be drawn on for strength, including the AA group” (a moot point, as any higher power of a transpersonal nature is religious in 12-step workings). Cited as reference for this are the two Browne studies, The selective adaptation of the Alcoholics Anonymous program by Gamblers Anonymous (1991) and Really not God: Secularization and pragmatism in Gamblers Anonymous (1994). Obviously, no AA group, Big Book study meeting or Steps meeting uses GA’s adaptation of its program. Though also 12-step, GA has a significantly different culture to AA, with 12 different, less religious steps - only 2 direct mentions of God - and is not anchored to AA’s 2 über religious main program texts. AA’s 12 Steps contain six references to God, eight of the 12 religious by nature. AA’s culture is steeped in its own deeply religious roots, history and related internal folklore. Members face religious peer pressure, discouragement from using the group as a higher power and legitimate reasons not to. AA’s main working texts specifically state, on the point of concepts of higher power, e.g. "From great numbers of such experiences, we could predict that the doubter ... would presently love God and call Him by name." (Twelve Steps and Twelve Traditions, page 109.)
The downplaying of AA’s religiosity in Guidelines for the Treatments of Alcohol Problems 2009 and Review of the Evidence is not the reality incoming or continuing AA members will encounter.
AA and religion
Effective participation in AA’s program requires engagement in religious activities and adoption of religious belief. This was last clinically examined in a 2010 study showing that AA effectiveness is facilitated specifically by spiritual/religious practices and beliefs, and that attending AA is associated with increases in spiritual practices (Kelly, et al).
Australia’s 2009 Guidelines for the Treatments of Alcohol Problems offers a brief, sanitised interpretation of AA’s 12 Steps in isolation (outlined in three points only), devoid of context. It is questionable whether the authors have thoroughly examined AA’s two main program texts as primary sources: Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism aka the Big Book, and Twelve Steps and Twelve Traditions. They would have found AA’s approach to be founded explicitly on the theological hypothesis that alcoholism is a “spiritual malady” only treatable by God.
Oxford Concise English Dictionary definition of “religious”: Devoted to religion; pious, or devout; of or concerned with religion. Oxford Concise English Dictionary definition of “religion”: The belief in a superhuman controlling power, esp in a God or gods entitled to obedience and worship.
Whilst one of AA’s most notable buzzwords is “denial”, there is none so great as AA’s of its own religiosity. The catchphrase “spiritual, not religious” has been systematically parroted down through the decades to wary AA newcomers, then re-parroted to subsequent newcomers, but repeatedly parroting internal propaganda can never make it objectively true. Sociologists David Rudy and Arthur Greil, who evaluated AA's literature and observed AA meetings for sixteen months, found that it would be impossible to participate without a religious conversion: “While A.A. denies it is a religion in order to realise better its therapeutic goals, its statement that it is ‘spiritual’ but not ‘religious’ is ambiguous. A.A. is properly classified as a quasi-religion in so far as a tension between sacred and secular is crucial to its functioning.” (Rudy & Greil). A more honest translation of “spiritual, not religious” would be “non-denominational”. The point is not whether AA represents any one religion, but that it is a religious organisation primarily.
Sound legal precedents exist of religious recognition of AA. United States courts have ruled that inmates, parolees and probationers cannot be ordered to attend AA. Though AA itself was not deemed a religion, it was ruled that it contained enough religious components (spirituality, god, prayer and proselytism) to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment of the constitution. There have been a number of such U.S. court cases since 1996, most recently on September 7 2007. The Ninth U.S. Circuit Court of Appeals in San Francisco noted "adherence to the AA fellowship entails engagement in religious activity and religious proselytism."(Apanovitch) (Egelco) (Ragge) In Australia no equivalent constitutional requirement exists for secular-based recovery program options to be offered in any mandatory penal sentencing... or in medical “Intensive Referral” processes. Intensive Referral has a sound basis for medicine, but not for theosophy, whereby it becomes religious coercion - and study after study has shown that coerced AA attendance (Ditman, et al) or 12 step group treatment programs (Brandsma, et al) are no more effective than doing nothing at all.
AA’s world headquarters, AA World Services Inc, meets criteria as a tenant agency of New York’s Interchurch Center, owned and managed under the auspices of several Christian organisations. The IC houses offices and agencies of various religions and ecumenical and interreligious organisations, with the mission “to provide a working environment conducive to ecumenism and interreligious involvement.”
AA’s Twelve Steps are a direct codification of AA’s predecessor the Oxford Group’s fundamentalist evangelical God-control tenets. AA’s charismatic Cofounder Bill Wilson acknowledged, "The early AA got its ideas of self-examination, acknowledgment of character defects, restitution for harm done and working with others straight from the Oxford Group and directly from Sam Shoemaker, their former leader in America, and from nowhere else." (Pittman).
The Oxford Group’s practices were called the Five C's: Confidence, Confession, Conviction, Conversion and Continuance. Their standard of morality was the Four Absolutes, a summary of the teachings of the Sermon on the Mount: Absolute-Honesty, Absolute-Purity, Absolute-Unselfishness and Absolute-Love. Oxford Group initiator, American Lutheran Minister Dr. Frank Nathan Daniel Buchman, had originally called his movement “A First Century Christian Fellowship" in 1921. Not originating in or otherwise connected to Oxford, England, Buchman renamed his movement in 1928, alluding to Oxford University for prestige. This successfully attracted thousands of adherents, many well-to-do. (Driberg.)
Buchman summed up the Oxford Group’s philosophy: “all people are sinners”; “all sinners can be changed”; “confession is a prerequisite to change”; “the change can access God directly”; “miracles are again possible”; and “the change must change others”. He made the cover of Time Magazine as "Cultist Frank Buchman: God is a Millionaire" (Time Magazine, 20 April 1936). Several months later he was featured in its pages, announcing to the world that Adolph Hitler would be an ideal candidate for a fascist, God–controlled state (Time Magazine, Sept 07 1936).
The Oxford Group was renamed Moral Re-Armament (MRA) in 1938. Unlike other forms of evangelism, the movement targeted society’s elite and wealthy, the "up and outers". Caricatured by critics as a "Salvation Army for snobs" it relied on publicity featuring prominent converts. (Mercandante.) The renamed MRA’s multimillion-dollar headquarters held 1,000 visitors. Buchman and his followers, known as Buchmanites, enjoyed the best on extravagant global evangelical progresses. Responding to related criticism 25 years after achieving fame, Buchman still unashamedly remarked: "Isn't God a millionaire?" (Time Magazine 1961.)
Buchman’s religion was known as Buchmanism. AA, therefore, is derived from Buchmanism. Wilson also borrowed and adapted the Oxford Group’s pitch line “more spiritual than religious” for AA, making it “spiritual, not religious”. Both the Oxford Group’s and AA’s versions of this catchphrase were contrived to minimise alienation from the Catholic and Protestant churches, from which both groups worked to draw assorted followers – although both groups were formally condemned by Episcopal accusations of heresy and occultism (Burns). Wilson transformed the Oxford Group’s 5C’s and Four Absolutes into AA’s Steps, creating twelve as a nod to the Bible’s Twelve Apostles.
Wilson admitted the exact identification between the Twelve Steps and Spiritual Exercises of St. Ignatius:
"My new Jesuit friends pointed to a chart that hung on the wall. They explained that this was a comparison between the Spiritual Exercises of St. Ignatius and the Twelve Steps of Alcoholics Anonymous, that, in principle, this correspondence was amazingly exact. I believe they also made the somewhat startling statement that spiritual principles set forth in our Twelve Steps appear in the same order that they do in the Ignatius Exercises ... While of course the Twelve Steps of AA contain nothing new, there seems no doubt that this singular and exact identification with the Ignatian Exercises has done much to make the close and fruitful relation that we now enjoy with the Church." (NCCA)
As one AA apostate, having undergone psychiatric 12 Step deprogramming therapy, warns on his recovery blog: “if it walks like a duck and talks like a duck = it’s a duck.” Of course, one may argue that his is not necessarily everyone’s experience.
There are 5 things that define a religion and AA has them all: 1. God or gods. 2. Ritual. 3. Sacred words or text. 4. Hierarchy. 5. Dogma.
1) AA requires submission of the individual to the “will of God”. AA defines what God will and will not do for members, instructs on what to pray for, what to expect in return.
2) Meetings follow the same format, using the same readings, chants, prayers.
3) The Big Book, the 12 & 12, the readings.
4) AA is built upon a charismatic leader, who is still worshipped and revered today. AA hails itself as egalitarian. In reality, AA has a hierarchical, authoritarian structure which cannot be questioned: besides the obvious ‘oldtimers’ who run the meetings, there are General Services Offices, Area Committees, all the way up to AA World Services in NYC (where six-digit salaries are collected for part-time work).
5) Dogma: the established belief or doctrine held by a religion, ideology or any kind of organisation; thought to be authoritative and not to be disputed, doubted or diverged from.
Steppism became a religion that has formed the basis of several well known offshoot cults. One was Synanon, which grew directly from an AA meeting and disbanded permanently in 1989 due to criminal activities, including attempted murder and tax-evasion. (Wikipedia.) Another was Heaven’s Gate, 39 members of which committed mass suicide in 1999 in order to reach an alien aircraft which they believed was following the Comet Hale-Bopp, which was at its brightest. (Russell). Steppism principles preach powerlessness, insanity, confession of moral shortcomings, restitution for harm done and carrying the message to others.
AA fellowship members practice Steppism (many unwittingly, unaware of its existence, beginnings or history). They are required to publicly brand themselves (stigmatise?), “My name is ... and I am an alcoholic” at every meeting they participate in. One study found that an AA program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity replacing it with the deviant identity. (Levison.)
The 2009 Guidelines for the Treatment of Alcohol Problems’ one-sided appraisal of AA’s Steps says they “promote increased self-awareness and heighten a sense of meaning in life.” Such is the reality for only a minority. High percentages of those actually trying to live by The Steps remain in AA less than one year. (AA World Services Inc, 1989.) Such participants commonly find that the general thrust of The Steps is to demolish the individual's sense of self and create dependence on AA, one author describing The Steps as "a prescription for helplessness, self-alienation and depression." (Ragge, 1998.) One of the first modern sociological studies of AA warned of detrimental iatrogenic effects of twelve-step philosophy. (Alexander & Rollins.)
The Big Book’s concluding Chapter 11, A Vision for You, encapsulates AA’s ominous, morally reckoning ideology, featuring the Four Horsemen of the Apocalypse: “As we became subjects of King Alcohol, shivering denizens of his mad realm, the chilling vapour that is loneliness settled down. It thickened, ever becoming blacker. Some of us sought out sordid places, hoping to find understanding companionship and approval. Momentarily we did -- then would come oblivion and the awful awakening to face the hideous Four Horsemen -- Terror, Bewilderment, Frustration, Despair.” (Big Book p 151.)
The Four Horsemen of the Apocalypse originated in the New Testament’s Book of Revelation of Jesus Christ to Saint John the Evangelist at 6:1-8. The chapter tells of a "'book'/'scroll' in God's right hand that is sealed with seven seals". The Lamb of God/Lion of Judah (Jesus Christ) opens the first four of the seven seals, which summons forth four beings that ride out on white, red, black, and pale horses. The four riders are commonly seen as symbolizing Conquest, War, Famine and Death, respectively. The Christian apocalyptic vision is that the four horsemen are to set a divine apocalypse upon the world as harbingers of the Last Judgment. (Flegg) (Van den Bieson)
This mythical symbolism relates directly to the roots of AA tenets, the “First Century Early Christian Fellowship” teachings that “all people are sinners”. British philosopher John N Gray writes, in his critique of Christianity and humanism, Straw Dogs: Thoughts on Humans and Other Animals: “To early followers of Jesus, sin meant disobedience to God, and punishment for sinful mankind was the end of the world. These mythic beliefs were linked with the figure of a messiah, a divine messenger who brought divine retribution to the world and redemption of the obedient few.” (Gray)
“Channelling” God’s 12-Steps onto the pages of the Big Book, AA’s narcissistic Cofounder Bill Wilson considered himself the messiah of alcoholics.
Effective participation in AA’s program requires engagement in religious activities and adoption of religious belief. This was last clinically examined in a 2010 study showing that AA effectiveness is facilitated specifically by spiritual/religious practices and beliefs, and that attending AA is associated with increases in spiritual practices (Kelly, et al).
Australia’s 2009 Guidelines for the Treatments of Alcohol Problems offers a brief, sanitised interpretation of AA’s 12 Steps in isolation (outlined in three points only), devoid of context. It is questionable whether the authors have thoroughly examined AA’s two main program texts as primary sources: Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism aka the Big Book, and Twelve Steps and Twelve Traditions. They would have found AA’s approach to be founded explicitly on the theological hypothesis that alcoholism is a “spiritual malady” only treatable by God.
Oxford Concise English Dictionary definition of “religious”: Devoted to religion; pious, or devout; of or concerned with religion. Oxford Concise English Dictionary definition of “religion”: The belief in a superhuman controlling power, esp in a God or gods entitled to obedience and worship.
Whilst one of AA’s most notable buzzwords is “denial”, there is none so great as AA’s of its own religiosity. The catchphrase “spiritual, not religious” has been systematically parroted down through the decades to wary AA newcomers, then re-parroted to subsequent newcomers, but repeatedly parroting internal propaganda can never make it objectively true. Sociologists David Rudy and Arthur Greil, who evaluated AA's literature and observed AA meetings for sixteen months, found that it would be impossible to participate without a religious conversion: “While A.A. denies it is a religion in order to realise better its therapeutic goals, its statement that it is ‘spiritual’ but not ‘religious’ is ambiguous. A.A. is properly classified as a quasi-religion in so far as a tension between sacred and secular is crucial to its functioning.” (Rudy & Greil). A more honest translation of “spiritual, not religious” would be “non-denominational”. The point is not whether AA represents any one religion, but that it is a religious organisation primarily.
Sound legal precedents exist of religious recognition of AA. United States courts have ruled that inmates, parolees and probationers cannot be ordered to attend AA. Though AA itself was not deemed a religion, it was ruled that it contained enough religious components (spirituality, god, prayer and proselytism) to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment of the constitution. There have been a number of such U.S. court cases since 1996, most recently on September 7 2007. The Ninth U.S. Circuit Court of Appeals in San Francisco noted "adherence to the AA fellowship entails engagement in religious activity and religious proselytism."(Apanovitch) (Egelco) (Ragge) In Australia no equivalent constitutional requirement exists for secular-based recovery program options to be offered in any mandatory penal sentencing... or in medical “Intensive Referral” processes. Intensive Referral has a sound basis for medicine, but not for theosophy, whereby it becomes religious coercion - and study after study has shown that coerced AA attendance (Ditman, et al) or 12 step group treatment programs (Brandsma, et al) are no more effective than doing nothing at all.
AA’s world headquarters, AA World Services Inc, meets criteria as a tenant agency of New York’s Interchurch Center, owned and managed under the auspices of several Christian organisations. The IC houses offices and agencies of various religions and ecumenical and interreligious organisations, with the mission “to provide a working environment conducive to ecumenism and interreligious involvement.”
AA’s Twelve Steps are a direct codification of AA’s predecessor the Oxford Group’s fundamentalist evangelical God-control tenets. AA’s charismatic Cofounder Bill Wilson acknowledged, "The early AA got its ideas of self-examination, acknowledgment of character defects, restitution for harm done and working with others straight from the Oxford Group and directly from Sam Shoemaker, their former leader in America, and from nowhere else." (Pittman).
The Oxford Group’s practices were called the Five C's: Confidence, Confession, Conviction, Conversion and Continuance. Their standard of morality was the Four Absolutes, a summary of the teachings of the Sermon on the Mount: Absolute-Honesty, Absolute-Purity, Absolute-Unselfishness and Absolute-Love. Oxford Group initiator, American Lutheran Minister Dr. Frank Nathan Daniel Buchman, had originally called his movement “A First Century Christian Fellowship" in 1921. Not originating in or otherwise connected to Oxford, England, Buchman renamed his movement in 1928, alluding to Oxford University for prestige. This successfully attracted thousands of adherents, many well-to-do. (Driberg.)
Buchman summed up the Oxford Group’s philosophy: “all people are sinners”; “all sinners can be changed”; “confession is a prerequisite to change”; “the change can access God directly”; “miracles are again possible”; and “the change must change others”. He made the cover of Time Magazine as "Cultist Frank Buchman: God is a Millionaire" (Time Magazine, 20 April 1936). Several months later he was featured in its pages, announcing to the world that Adolph Hitler would be an ideal candidate for a fascist, God–controlled state (Time Magazine, Sept 07 1936).
The Oxford Group was renamed Moral Re-Armament (MRA) in 1938. Unlike other forms of evangelism, the movement targeted society’s elite and wealthy, the "up and outers". Caricatured by critics as a "Salvation Army for snobs" it relied on publicity featuring prominent converts. (Mercandante.) The renamed MRA’s multimillion-dollar headquarters held 1,000 visitors. Buchman and his followers, known as Buchmanites, enjoyed the best on extravagant global evangelical progresses. Responding to related criticism 25 years after achieving fame, Buchman still unashamedly remarked: "Isn't God a millionaire?" (Time Magazine 1961.)
Buchman’s religion was known as Buchmanism. AA, therefore, is derived from Buchmanism. Wilson also borrowed and adapted the Oxford Group’s pitch line “more spiritual than religious” for AA, making it “spiritual, not religious”. Both the Oxford Group’s and AA’s versions of this catchphrase were contrived to minimise alienation from the Catholic and Protestant churches, from which both groups worked to draw assorted followers – although both groups were formally condemned by Episcopal accusations of heresy and occultism (Burns). Wilson transformed the Oxford Group’s 5C’s and Four Absolutes into AA’s Steps, creating twelve as a nod to the Bible’s Twelve Apostles.
Wilson admitted the exact identification between the Twelve Steps and Spiritual Exercises of St. Ignatius:
"My new Jesuit friends pointed to a chart that hung on the wall. They explained that this was a comparison between the Spiritual Exercises of St. Ignatius and the Twelve Steps of Alcoholics Anonymous, that, in principle, this correspondence was amazingly exact. I believe they also made the somewhat startling statement that spiritual principles set forth in our Twelve Steps appear in the same order that they do in the Ignatius Exercises ... While of course the Twelve Steps of AA contain nothing new, there seems no doubt that this singular and exact identification with the Ignatian Exercises has done much to make the close and fruitful relation that we now enjoy with the Church." (NCCA)
As one AA apostate, having undergone psychiatric 12 Step deprogramming therapy, warns on his recovery blog: “if it walks like a duck and talks like a duck = it’s a duck.” Of course, one may argue that his is not necessarily everyone’s experience.
There are 5 things that define a religion and AA has them all: 1. God or gods. 2. Ritual. 3. Sacred words or text. 4. Hierarchy. 5. Dogma.
1) AA requires submission of the individual to the “will of God”. AA defines what God will and will not do for members, instructs on what to pray for, what to expect in return.
2) Meetings follow the same format, using the same readings, chants, prayers.
3) The Big Book, the 12 & 12, the readings.
4) AA is built upon a charismatic leader, who is still worshipped and revered today. AA hails itself as egalitarian. In reality, AA has a hierarchical, authoritarian structure which cannot be questioned: besides the obvious ‘oldtimers’ who run the meetings, there are General Services Offices, Area Committees, all the way up to AA World Services in NYC (where six-digit salaries are collected for part-time work).
5) Dogma: the established belief or doctrine held by a religion, ideology or any kind of organisation; thought to be authoritative and not to be disputed, doubted or diverged from.
Steppism became a religion that has formed the basis of several well known offshoot cults. One was Synanon, which grew directly from an AA meeting and disbanded permanently in 1989 due to criminal activities, including attempted murder and tax-evasion. (Wikipedia.) Another was Heaven’s Gate, 39 members of which committed mass suicide in 1999 in order to reach an alien aircraft which they believed was following the Comet Hale-Bopp, which was at its brightest. (Russell). Steppism principles preach powerlessness, insanity, confession of moral shortcomings, restitution for harm done and carrying the message to others.
AA fellowship members practice Steppism (many unwittingly, unaware of its existence, beginnings or history). They are required to publicly brand themselves (stigmatise?), “My name is ... and I am an alcoholic” at every meeting they participate in. One study found that an AA program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity replacing it with the deviant identity. (Levison.)
The 2009 Guidelines for the Treatment of Alcohol Problems’ one-sided appraisal of AA’s Steps says they “promote increased self-awareness and heighten a sense of meaning in life.” Such is the reality for only a minority. High percentages of those actually trying to live by The Steps remain in AA less than one year. (AA World Services Inc, 1989.) Such participants commonly find that the general thrust of The Steps is to demolish the individual's sense of self and create dependence on AA, one author describing The Steps as "a prescription for helplessness, self-alienation and depression." (Ragge, 1998.) One of the first modern sociological studies of AA warned of detrimental iatrogenic effects of twelve-step philosophy. (Alexander & Rollins.)
The Big Book’s concluding Chapter 11, A Vision for You, encapsulates AA’s ominous, morally reckoning ideology, featuring the Four Horsemen of the Apocalypse: “As we became subjects of King Alcohol, shivering denizens of his mad realm, the chilling vapour that is loneliness settled down. It thickened, ever becoming blacker. Some of us sought out sordid places, hoping to find understanding companionship and approval. Momentarily we did -- then would come oblivion and the awful awakening to face the hideous Four Horsemen -- Terror, Bewilderment, Frustration, Despair.” (Big Book p 151.)
The Four Horsemen of the Apocalypse originated in the New Testament’s Book of Revelation of Jesus Christ to Saint John the Evangelist at 6:1-8. The chapter tells of a "'book'/'scroll' in God's right hand that is sealed with seven seals". The Lamb of God/Lion of Judah (Jesus Christ) opens the first four of the seven seals, which summons forth four beings that ride out on white, red, black, and pale horses. The four riders are commonly seen as symbolizing Conquest, War, Famine and Death, respectively. The Christian apocalyptic vision is that the four horsemen are to set a divine apocalypse upon the world as harbingers of the Last Judgment. (Flegg) (Van den Bieson)
This mythical symbolism relates directly to the roots of AA tenets, the “First Century Early Christian Fellowship” teachings that “all people are sinners”. British philosopher John N Gray writes, in his critique of Christianity and humanism, Straw Dogs: Thoughts on Humans and Other Animals: “To early followers of Jesus, sin meant disobedience to God, and punishment for sinful mankind was the end of the world. These mythic beliefs were linked with the figure of a messiah, a divine messenger who brought divine retribution to the world and redemption of the obedient few.” (Gray)
“Channelling” God’s 12-Steps onto the pages of the Big Book, AA’s narcissistic Cofounder Bill Wilson considered himself the messiah of alcoholics.
The 12 Steps
AA’s Steps, containing only one reference to alcohol, one to alcoholics and six to God, are not an initial “quit drinking” program, but a religious philosophy prescribed for the rest of a member’s life, long after putting down her last drink. The Big Book’s occult-like introduction to the Steps, read aloud at every meeting, invokes fear of the inanimate substance AA has demonised into a sinister, sentient entity personifying God’s and the alcoholic’s nemesis: “Remember that we deal with alcohol - cunning, baffling and powerful. Without help it is too much for us. But there is One who has all power - that One is God. May you find Him now.” (Big Book, Chapter 5, p58-59.)
Step 1. We admitted we were powerless over alcohol - that our lives had become unmanageable.
This Step, as noted in Australia's Guidelines for the Treatments of Alcohol Problems 2009, sets clear and useful boundaries concerning the necessity of abstinence over controlled drinking, for effective address of alcohol dependency. Yet this is the Step targeted with the most harm-reductionist criticism. Teaching alcohol abusers trying to quit, that they cannot control their drinking after the first drink, has been clinically shown to become a disempowering, self-fulfilling prophecy which, once internalised into a member’s belief system, causes binge drinking on relapse (which is a common feature of the early recovery process). The Brandsma study showed that exposure to AA resulted in five times as much binge drinking as the group that received no treatment and nine times as much as the group that received rational behaviour therapy (Brandsma et al).
Bankole A. Johnson, Chairman of the University of Virginia’s department of psychiatry and neurobehavioral sciences and author of "The Rehab Myth: New Medications That Conquer Alcoholism" observes that AA’s philosophy “can be harmful to patients who chronically relapse. AA holds that, once a person starts to slip, he or she is powerless to stop. The stronger an alcoholic's belief in this perspective, the longer and more damaging relapses can be. An evening of drinking turns into a month-long bender.” (Johnson, 2010.)
Harriet A. Hall, MD, editor of Science-Based Medicine, succinctly notes, “They are not powerless over the addiction. They have the power to change their behaviour and to refuse to drink. They exercise that power in AA; isn’t that what it’s all about? Even if they believe God is deciding for them and helping them refuse that next drink, they are the ones who are actually carrying out the behaviour. What’s wrong with emphasising that?”
Cynthia Perkins M.Ed., sobriety counsellor and author of Get Sober, Stay Sober: The Truth about Alcoholism, writes “Alcoholics are not powerless over alcohol or the addiction process and do not have to be sentenced to a lifetime of meetings and the 12 step program of AA. Unlike other support groups, it demands that you attend for the rest of your life and engage in a variety of religious practices to be an accepted member. Like other support groups, attendance in AA should be voluntary and used as a transitional phase for early stages of recovery, not something you're sentenced to for the rest of your life. Alcoholics have been lied to and brainwashed.” (Perkins.)
Other research shows that AA's teaching of loss of control after the first drink, or “powerlessness”, is not merely dangerous, but based on fallacy. One famous study showed that alcoholics who drink disguised amounts of alcohol drink less than those who think they are drinking alcohol but are not (Marlatt, et al). “Expectancies” studies revealed that personal beliefs about whether a drink contains alcohol, and the specific outcomes expected from consuming alcohol, are more predictive of subsequent behaviour than the pharmacological effects of the drug (Carson-DeWitt & Macmillan-Thomson).
E.g. In a balanced-placebo designed study, half the participants are given a drink that they are told contains vodka and tonic, and half are given a drink that they are told contains only tonic. Half of each group receives vodka and tonic, while the other half receives only tonic, resulting in four groups: 1 Those who expect vodka and tonic and receive vodka and tonic. 2 Those who expect vodka and tonic and receive only tonic. 3 Those who expect tonic and receive vodka and tonic. 4 Those who expect tonic and receive tonic.
Thus, some who expect alcohol received only tonic, and some who expect only tonic receive a mix containing alcohol. Observational outcome: the most powerful behavioural predictor is not whether subjects are drinking alcohol, but whether they believe they are drinking alcohol. Those expecting alcohol consume significantly more drink than those not expecting alcohol, regardless of whether or not they receive alcohol. Even in those considered alcohol dependent, this offered contrasting evidence to the disease model's theory of "loss of control" caused exclusively by the pharmacological effects of alcohol. (Marlatt & Gordon, 1985).
Jeffrey Schaler's didactic Addiction is a Choice discussed the misguided teachings of powerlessness in 1999. Ten years later, Harvard psychologist Gene M Heyman’s Addiction: A Disorder of Choice detailed clinical and standard situations in which addicts and alcoholics do selectively exercise control over their addictions. These two important works broke boundaries of academic debate on the topic, demonstrating “loss of control” to be a learnt unhelpful mindset rather than a biochemical reality. (Schaler, 2000) (Heyman)
Step 2. Came to believe that a Power greater than ourselves could restore us to sanity.
As the latter part of that sentence spells out, the inductee is taught to believe she is insane. This teaching is rationalised by Albert Einstein’s (1897-1955) oft repeated quote: “Insanity: doing the same thing over and over again and expecting different results.” Whilst the medical profession has long since abandoned insanity in favor of diagnoses of specific mental illness such as schizophrenia and other psychotic disorders, AA members still use it to describe their condition, AA fundamentalists taking the word literally. The World Health Organisation estimates that about 140 million people throughout the world suffer from alcohol-related disorders. If these were actually insane, imagine the number of secure psychiatric institutions needed to section them for the protection of themselves and others. But the bottom line in AA is that unless they treat their insanity, with the 12-Steps, every one of them does indeed face “jails, institutions and death.”
Struggling with the former part of Step 2’s wording, any non-religious inductee trying to “come to believe” in an omnipotent, sentient, supernatural Creator holding a master plan for her destiny and jealously concerned with her every move, is urged along by the groupspeak slogan, “fake it til you make it”.
The common effect of Step 2 upon non-religious newcomers is acute cognitive dissonance, a discomfort caused by holding conflicting ideas simultaneously, one of the most extensively studied theories in social psychology (Festinger.) “Coming to believe” (adopting a borrowed belief system as a means to an ends) is ideologically antithetical to the definition of belief: the psychological state in which an individual holds a proposition or premise to be true. NOT what they hope might be true – that is faith, which is, by definition, blind. Advocates of faith argue that the proper domain of faith concerns questions which cannot be settled by evidence. Atheists and agnostics criticise religious faith as superstition, categorising it with other forms of belief that are not based on measurement of material things. To this group, belief is, by definition, restricted to what is directly supportable by logic or scientific evidence. (Walker.)
Step 2, then, is based on faith healing which may, for true believers, have placebo-like benefits, but for others is mere “spiritual snake oil”. (Yet this is exactly what the Australian government’s Guidelines 2009 and Review of the Evidence 2009 recommend Assertive/Intensive Referral to – how much credibility can such recommendation lend medicine in the eyes of Australia’s 4 in 5 alcohol disorder sufferers not seeking help and “not confident in the treatment that exists”?)
For non-believers, who choose to understand reality through facts, logic and reason rather than falsehood, fallacy and superstition, Step 2 is futile without conversion to a religious belief system.
The non-religious also run into a second Step 2 stumbling block, on learning from their mentors that the 12 Steps may only be executed in numerical order to work. The non-religious cannot move on through the program and participate without having undergone this religious conversion.
Step 3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
“God as we understand Him” might, admittedly, be an inanimate object in AA, like a doorknob or a light bulb. However, anyone considering surrendering their will and their life to a doorknob is still not escaping religious practice, but merely entering the religion of fetishism or idolatry (or, arguably, a more literal level of “insanity”). AA’s central working text is specific, offering no mention of idolatrous alternatives: “We decided that hereafter in this drama of life, God was going to be our Director. He is the principal; we are His agents. He is the Father, and we are His children....this concept was the keystone of the new and triumphant arch through which we passed to freedom.” (Big Book p62.) Most would consider AA’s Third Step 3 prayer an odd thing to say to an inanimate object, a group or anything other than God: “God... relieve me of the bondage of self” (Big Book p63). Surrender to God is without compromise, and the ideally indoctrinated AA member frequently shares at meetings that they “hope and pray to God I’ll never get the idea I am in control of my life.”
AA apologists have argued that the rest of the group could pray for non-believing members not willing to engage in prayer themselves for their healing. A $2.4 million study gathered quantitative data regarding prayer-induced healing. The findings, published in 2006 by the National Center for Biotechnology Information, concluded that there was no difference between those being prayed for and those who were not, while those who knew they were being prayed for actually came off worse than those who did not (Benson, at al.) Richard Dawkins, preeminent biologist and professorial fellow of New College, Oxford, famously described ritualistic religious activity as “Carnival of Delusion” (Dawkins, 2006.) This is how unsuitably referred non-believers have perceived AA meetings, evident in the expansive spread of online AA-bashing and deprogramming forums. Moderate debate about AA has found voice on Richard Dawkins’ Foundation for Reason and Science website (Dawkins, 2011.) Dawkins’ position, intrinsic to the secular-minded Australian AA casualty, is summed up in Robert M. Pirsig's Lila: An Inquiry into Morals: "When one person suffers from a delusion it is called insanity. When many people suffer from a delusion it is called religion." (Pirsig.) Health, argues Dawkins, has become a battle ground for reason and superstition. He contends that a supernatural creator almost certainly does not exist and that belief in a personal god qualifies as a delusion, which he defines as a persistent false belief held in the face of strong contradictory evidence. Dawkins’ much touted line, “Why won’t God heal amputees?” is borrowed as title of a 32 chapter e-book, which Dawkins advocates as “a splendid site”. http://whywontgodhealamputees.com/god5.htm
Other AA proponents have suggested that non-believers use the group itself as the Higher Power. The popular objection to this idea is that surrendering one’s will and life to a quasi-religious group is cult practice, leaving the person open to gang-manipulation through guilt and exploitation (more on this in this paper, section 'Common Misperceptions of AA’s Benignity'). AA undertakes no external restriction, screening, or vetting of its members. Although a statement is read aloud at meetings, that what is said there should remain confidential, AA members, unlike lawyers or clergy, are not legally bound to maintain confidentiality – this has resulted in well documented, harmful breaches of confidentiality. (Coleman) (Hoffman) (Associated Press)
Step 4. Made a searching and fearless moral inventory of ourselves.
They must next “make a searching and fearless moral inventory of ourselves.” Most agree that all people have traits. Yet on closer reading of AA’s central texts, “defects of character” turns out to be AA code for ‘sins’: “Now let's ponder the need for a list of the more glaring personality defects all of us have in varying degrees... To avoid falling into confusion over the names these defects should be called, let's take a universally recognized list of major human failings — the Seven Deadly Sins of pride, greed, lust, anger, gluttony, envy, sloth.” (12 & 12 p48.)
Contrary to stereotyping, most individuals reaching out for help with alcohol disorders did not acquire their condition as a result of moral deficiency, nor did most become morally deficient as a result of their intake. Furthermore, in the secular western world of the 21st century, most people live according to their own moral code. Neither saints nor sinners, a significant proportion of Australian alcohol disorder sufferers became slaves to their poison reacting to childhood abuse, domestic violence, rape, extreme grief, Post Traumatic Stress Disorder, sexual or racial discrimination, social loneliness or poverty. This significant group must, perversely, in AA’s Step 4, find ways of taking personal responsibility for the involuntary misfortune triggering their lives of self-medicated torment, and then make direct amends to their perpetrators and all concerned. Those needing to share the pain of such events risk being told by the group to “get off the pity pot”. One YouTube recording of an AA meeting speaker, blaming the victim of sexual abuse and giving the compassion to the predator, is captioned “All for the moral inventory in the twelve steps of alcoholics anonymous.” (Chihuahuazz.) The speaker on this recording verbally berates the victim, "... you somehow think that it’s your right to suffer?" This is recommended listening for referring practitioners. Here is the world you are recommending patients to for care. The YouTube URL is http://www.youtube.com/watch?v=hcGtSzd9Tzo
Step 5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
AA’s most prolific contemporary critic, A. Orange, writes how this puts the inductee in the humiliating position of confessing to, preferably, their unqualified, ethically-unbound, accountability-free AA sponsor or another AA member, “every most intimate dirty little secret” of their entire life. This places them at risk of potential future personal exploitation and of the gratuitous malice of mentally unstable, disgruntled ex-sponsors (Orange.)
Ken Ragge, in The Real AA: The Myth Behind 12-Step Recovery, gives an analysis of the fourth and fifth steps as a bait-and-switch from the medical to the moral model: here the program takes the inductee through a fundamental paradigm switch. Earlier, the newcomer's problem was defined as a medical disease. Now "medical" is morphed into "moral" and the message is that the individual drank because of "defects of character." This immediately reloads the burden of guilt and shame that the medical disease theory might have discharged, and the individual now defines herself as a thoroughly bad and worthless person. Survival beyond this point is possible only through divine grace; redemption is attainable only by bringing in others to start the process anew (Ragge, 1998.)
Step 6. Were entirely ready to have God remove all these defects of character.
Paul A. Toth discusses Step 6 and ramifications for nationwide medical malpractice in referring a patient with a “medical” disease to a recovery program that requires supernatural removal of “moral character defects” (Toth). Here again, as in Step 4, AA’s main program texts state specifically, in Step 6, what is meant by character defects: “That is the measure of our character defects, or, if you wish, of our sins.” (12 & 12 p 65). And so again, the question presents itself: how does Australia’s government justify instruction of Intensive AA Referral, made by medical professionals bound by Hippocratic Oath, to a pseudoscientific quasi-religion which addresses alcohol disorders by praying for removal of sins?
Step 7. Humbly asked Him to remove our shortcomings.
Non-religious Australians told they can benefit from AA may take justifiable issue. This Step has its own essential prayer, “said in a humbling position”. Hoping to use a doorknob as a higher power, non-believers find this step particularly perplexing. 7th Step Prayer said aloud on bended knee to said doorknob: “My Creator, I am now willing that you should have all of me, good and bad. I pray that you now remove from me every single defect of character which stands in the way of my usefulness to you and my fellows. Grant me strength, as I go out from here, to do your bidding. Amen.” (Big Bookp76.)
Step 8. Made a list of all persons we had harmed, and became willing to make amends to them all. Step 9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
Excerpted from Ken Ragge’s The Real AA: Behind the Myth of 12-Step Recovery:
These Steps, like the others, mimic the spiritual principles of the world’s great religions. However, in AA “making amends,” elsewhere known as “atoning for one’s sins,” is also perverted. The major motivation for making amends in AA is not regret, but fear of drinking and dying. Also important is the promise of being “catapulted into the fourth dimension of existence” for “painstakingly” working the Steps.
This distorts the purpose behind acts of atonement. When a grouper makes amends, he isn’t necessarily sorry. Of course, any act he does regret will make the list of Step Eight and amends will be made in Step Nine. However, he also is likely to “make amends” he wouldn’t make if he valued his better judgment. In AA, if one’s better judgment does not agree with the elders, it is merely “one’s disease speaking.” It is wilfulness and self-centeredness.
This Step is often carried to ridiculous extremes. For example, one woman shared at a meeting that her sponsor had told her she must make amends in a situation where she had serious misgivings.
While alone in a ladies room, she was confronted by a man standing in front of her masturbating. Shocked and frightened, she screamed at him to get out. He didn’t blink. She screamed at him again. He still neither stopped nor left. Probably more out of panic than anything else, she hit him. Her sponsor told her that while what the man had done may have been wrong, it was her responsibility to “keep her own side of the street clean.” She needed to make amends to him. Her “sobriety” was at stake.
While this example may seem extreme, this woman’s plight is not unusual in AA. It is entirely consistent with AA’s view of the “alcoholic” as “bad child,” sinner or hopeless defective. Doubtless her sponsor saw, and she herself worried, that not wanting to make amends was a dangerous “manifestation of self.” She was humiliated by the exhibitionist. If she actually carried out “making amends” she would have felt humiliated again. In AA, “humiliation = humility.” It is a good emotion. (Ragge, 1998.)
Step 10. Continued to take personal inventory and when we were wrong promptly admitted it.
By Step 10 the inductee has learnt that recovery can only be possible when one puts one’s life in God’s hands. Even then, however, only a daily reprieve is all that is promised (“we are never cured of alcoholism”), contingent on daily prayer. Again, this Step has its own specific prayer. Non-believer on bended knee addresses light bulb: "How can I best serve Thee, Thy will (not mine) be done."
Step 11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
And another specifically worded, text-prescribed prayer to the doorknob: “Thy will be done.” (12&12 p103.) This Step renders the AA inductee reliant on divine guidance - which must be checked for legitimacy with her sponsor, who is more experienced and thought better able to determine whether the “guidance” received is authentic or a product of the inductee’s ‘early recovery’ imagination. The sponsor’s role here extends to correcting any imagined guidance of the novice, and re-instructing with “legitimate” divine guidance. And so the sponsor becomes God’s representative and interpreter. Usually spiritual guidance is given by priests, pastors, rabbis and religious leaders. The sponsor, however, is not a professionally educated spiritual director or pastoral counsellor. Many sponsors, all recovering addicts themselves, have co-dependency issues. Some also have mental health issues, diagnosed or undiagnosed, treated or untreated. Some may knowingly or unknowingly abuse this position of intimate trust and authority.
Step 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
This entails recruitment of new inductees (victims of an insidious and misleading indoctrination process becoming perpetrators). One defining word for “carrying the message” of God’s help is “evangelism”, which refers to the practice of relaying information about a particular set of beliefs to others who do not hold those beliefs. Another is proselytism, which describes the act of attempting to convert people to another opinion and, particularly, another religion. Neither has any remote connection to alcohol abuse disorder. Evangelism and proselytism are specifically religious, another example of this paper’s recurring point that government recommendations for Intensive Referral to AA for the non-religious, on unproven superior therapeutic grounds, are naive and misguided or dishonest and religiously coercive – particularly in cases when the client’s government welfare benefits (Sickness Allowance, Disability Support) are conditional to compliance with a recognised recovery strategy such as AA.
AA’s Steps, containing only one reference to alcohol, one to alcoholics and six to God, are not an initial “quit drinking” program, but a religious philosophy prescribed for the rest of a member’s life, long after putting down her last drink. The Big Book’s occult-like introduction to the Steps, read aloud at every meeting, invokes fear of the inanimate substance AA has demonised into a sinister, sentient entity personifying God’s and the alcoholic’s nemesis: “Remember that we deal with alcohol - cunning, baffling and powerful. Without help it is too much for us. But there is One who has all power - that One is God. May you find Him now.” (Big Book, Chapter 5, p58-59.)
Step 1. We admitted we were powerless over alcohol - that our lives had become unmanageable.
This Step, as noted in Australia's Guidelines for the Treatments of Alcohol Problems 2009, sets clear and useful boundaries concerning the necessity of abstinence over controlled drinking, for effective address of alcohol dependency. Yet this is the Step targeted with the most harm-reductionist criticism. Teaching alcohol abusers trying to quit, that they cannot control their drinking after the first drink, has been clinically shown to become a disempowering, self-fulfilling prophecy which, once internalised into a member’s belief system, causes binge drinking on relapse (which is a common feature of the early recovery process). The Brandsma study showed that exposure to AA resulted in five times as much binge drinking as the group that received no treatment and nine times as much as the group that received rational behaviour therapy (Brandsma et al).
Bankole A. Johnson, Chairman of the University of Virginia’s department of psychiatry and neurobehavioral sciences and author of "The Rehab Myth: New Medications That Conquer Alcoholism" observes that AA’s philosophy “can be harmful to patients who chronically relapse. AA holds that, once a person starts to slip, he or she is powerless to stop. The stronger an alcoholic's belief in this perspective, the longer and more damaging relapses can be. An evening of drinking turns into a month-long bender.” (Johnson, 2010.)
Harriet A. Hall, MD, editor of Science-Based Medicine, succinctly notes, “They are not powerless over the addiction. They have the power to change their behaviour and to refuse to drink. They exercise that power in AA; isn’t that what it’s all about? Even if they believe God is deciding for them and helping them refuse that next drink, they are the ones who are actually carrying out the behaviour. What’s wrong with emphasising that?”
Cynthia Perkins M.Ed., sobriety counsellor and author of Get Sober, Stay Sober: The Truth about Alcoholism, writes “Alcoholics are not powerless over alcohol or the addiction process and do not have to be sentenced to a lifetime of meetings and the 12 step program of AA. Unlike other support groups, it demands that you attend for the rest of your life and engage in a variety of religious practices to be an accepted member. Like other support groups, attendance in AA should be voluntary and used as a transitional phase for early stages of recovery, not something you're sentenced to for the rest of your life. Alcoholics have been lied to and brainwashed.” (Perkins.)
Other research shows that AA's teaching of loss of control after the first drink, or “powerlessness”, is not merely dangerous, but based on fallacy. One famous study showed that alcoholics who drink disguised amounts of alcohol drink less than those who think they are drinking alcohol but are not (Marlatt, et al). “Expectancies” studies revealed that personal beliefs about whether a drink contains alcohol, and the specific outcomes expected from consuming alcohol, are more predictive of subsequent behaviour than the pharmacological effects of the drug (Carson-DeWitt & Macmillan-Thomson).
E.g. In a balanced-placebo designed study, half the participants are given a drink that they are told contains vodka and tonic, and half are given a drink that they are told contains only tonic. Half of each group receives vodka and tonic, while the other half receives only tonic, resulting in four groups: 1 Those who expect vodka and tonic and receive vodka and tonic. 2 Those who expect vodka and tonic and receive only tonic. 3 Those who expect tonic and receive vodka and tonic. 4 Those who expect tonic and receive tonic.
Thus, some who expect alcohol received only tonic, and some who expect only tonic receive a mix containing alcohol. Observational outcome: the most powerful behavioural predictor is not whether subjects are drinking alcohol, but whether they believe they are drinking alcohol. Those expecting alcohol consume significantly more drink than those not expecting alcohol, regardless of whether or not they receive alcohol. Even in those considered alcohol dependent, this offered contrasting evidence to the disease model's theory of "loss of control" caused exclusively by the pharmacological effects of alcohol. (Marlatt & Gordon, 1985).
Jeffrey Schaler's didactic Addiction is a Choice discussed the misguided teachings of powerlessness in 1999. Ten years later, Harvard psychologist Gene M Heyman’s Addiction: A Disorder of Choice detailed clinical and standard situations in which addicts and alcoholics do selectively exercise control over their addictions. These two important works broke boundaries of academic debate on the topic, demonstrating “loss of control” to be a learnt unhelpful mindset rather than a biochemical reality. (Schaler, 2000) (Heyman)
Step 2. Came to believe that a Power greater than ourselves could restore us to sanity.
As the latter part of that sentence spells out, the inductee is taught to believe she is insane. This teaching is rationalised by Albert Einstein’s (1897-1955) oft repeated quote: “Insanity: doing the same thing over and over again and expecting different results.” Whilst the medical profession has long since abandoned insanity in favor of diagnoses of specific mental illness such as schizophrenia and other psychotic disorders, AA members still use it to describe their condition, AA fundamentalists taking the word literally. The World Health Organisation estimates that about 140 million people throughout the world suffer from alcohol-related disorders. If these were actually insane, imagine the number of secure psychiatric institutions needed to section them for the protection of themselves and others. But the bottom line in AA is that unless they treat their insanity, with the 12-Steps, every one of them does indeed face “jails, institutions and death.”
Struggling with the former part of Step 2’s wording, any non-religious inductee trying to “come to believe” in an omnipotent, sentient, supernatural Creator holding a master plan for her destiny and jealously concerned with her every move, is urged along by the groupspeak slogan, “fake it til you make it”.
The common effect of Step 2 upon non-religious newcomers is acute cognitive dissonance, a discomfort caused by holding conflicting ideas simultaneously, one of the most extensively studied theories in social psychology (Festinger.) “Coming to believe” (adopting a borrowed belief system as a means to an ends) is ideologically antithetical to the definition of belief: the psychological state in which an individual holds a proposition or premise to be true. NOT what they hope might be true – that is faith, which is, by definition, blind. Advocates of faith argue that the proper domain of faith concerns questions which cannot be settled by evidence. Atheists and agnostics criticise religious faith as superstition, categorising it with other forms of belief that are not based on measurement of material things. To this group, belief is, by definition, restricted to what is directly supportable by logic or scientific evidence. (Walker.)
Step 2, then, is based on faith healing which may, for true believers, have placebo-like benefits, but for others is mere “spiritual snake oil”. (Yet this is exactly what the Australian government’s Guidelines 2009 and Review of the Evidence 2009 recommend Assertive/Intensive Referral to – how much credibility can such recommendation lend medicine in the eyes of Australia’s 4 in 5 alcohol disorder sufferers not seeking help and “not confident in the treatment that exists”?)
For non-believers, who choose to understand reality through facts, logic and reason rather than falsehood, fallacy and superstition, Step 2 is futile without conversion to a religious belief system.
The non-religious also run into a second Step 2 stumbling block, on learning from their mentors that the 12 Steps may only be executed in numerical order to work. The non-religious cannot move on through the program and participate without having undergone this religious conversion.
Step 3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
“God as we understand Him” might, admittedly, be an inanimate object in AA, like a doorknob or a light bulb. However, anyone considering surrendering their will and their life to a doorknob is still not escaping religious practice, but merely entering the religion of fetishism or idolatry (or, arguably, a more literal level of “insanity”). AA’s central working text is specific, offering no mention of idolatrous alternatives: “We decided that hereafter in this drama of life, God was going to be our Director. He is the principal; we are His agents. He is the Father, and we are His children....this concept was the keystone of the new and triumphant arch through which we passed to freedom.” (Big Book p62.) Most would consider AA’s Third Step 3 prayer an odd thing to say to an inanimate object, a group or anything other than God: “God... relieve me of the bondage of self” (Big Book p63). Surrender to God is without compromise, and the ideally indoctrinated AA member frequently shares at meetings that they “hope and pray to God I’ll never get the idea I am in control of my life.”
AA apologists have argued that the rest of the group could pray for non-believing members not willing to engage in prayer themselves for their healing. A $2.4 million study gathered quantitative data regarding prayer-induced healing. The findings, published in 2006 by the National Center for Biotechnology Information, concluded that there was no difference between those being prayed for and those who were not, while those who knew they were being prayed for actually came off worse than those who did not (Benson, at al.) Richard Dawkins, preeminent biologist and professorial fellow of New College, Oxford, famously described ritualistic religious activity as “Carnival of Delusion” (Dawkins, 2006.) This is how unsuitably referred non-believers have perceived AA meetings, evident in the expansive spread of online AA-bashing and deprogramming forums. Moderate debate about AA has found voice on Richard Dawkins’ Foundation for Reason and Science website (Dawkins, 2011.) Dawkins’ position, intrinsic to the secular-minded Australian AA casualty, is summed up in Robert M. Pirsig's Lila: An Inquiry into Morals: "When one person suffers from a delusion it is called insanity. When many people suffer from a delusion it is called religion." (Pirsig.) Health, argues Dawkins, has become a battle ground for reason and superstition. He contends that a supernatural creator almost certainly does not exist and that belief in a personal god qualifies as a delusion, which he defines as a persistent false belief held in the face of strong contradictory evidence. Dawkins’ much touted line, “Why won’t God heal amputees?” is borrowed as title of a 32 chapter e-book, which Dawkins advocates as “a splendid site”. http://whywontgodhealamputees.com/god5.htm
Other AA proponents have suggested that non-believers use the group itself as the Higher Power. The popular objection to this idea is that surrendering one’s will and life to a quasi-religious group is cult practice, leaving the person open to gang-manipulation through guilt and exploitation (more on this in this paper, section 'Common Misperceptions of AA’s Benignity'). AA undertakes no external restriction, screening, or vetting of its members. Although a statement is read aloud at meetings, that what is said there should remain confidential, AA members, unlike lawyers or clergy, are not legally bound to maintain confidentiality – this has resulted in well documented, harmful breaches of confidentiality. (Coleman) (Hoffman) (Associated Press)
Step 4. Made a searching and fearless moral inventory of ourselves.
They must next “make a searching and fearless moral inventory of ourselves.” Most agree that all people have traits. Yet on closer reading of AA’s central texts, “defects of character” turns out to be AA code for ‘sins’: “Now let's ponder the need for a list of the more glaring personality defects all of us have in varying degrees... To avoid falling into confusion over the names these defects should be called, let's take a universally recognized list of major human failings — the Seven Deadly Sins of pride, greed, lust, anger, gluttony, envy, sloth.” (12 & 12 p48.)
Contrary to stereotyping, most individuals reaching out for help with alcohol disorders did not acquire their condition as a result of moral deficiency, nor did most become morally deficient as a result of their intake. Furthermore, in the secular western world of the 21st century, most people live according to their own moral code. Neither saints nor sinners, a significant proportion of Australian alcohol disorder sufferers became slaves to their poison reacting to childhood abuse, domestic violence, rape, extreme grief, Post Traumatic Stress Disorder, sexual or racial discrimination, social loneliness or poverty. This significant group must, perversely, in AA’s Step 4, find ways of taking personal responsibility for the involuntary misfortune triggering their lives of self-medicated torment, and then make direct amends to their perpetrators and all concerned. Those needing to share the pain of such events risk being told by the group to “get off the pity pot”. One YouTube recording of an AA meeting speaker, blaming the victim of sexual abuse and giving the compassion to the predator, is captioned “All for the moral inventory in the twelve steps of alcoholics anonymous.” (Chihuahuazz.) The speaker on this recording verbally berates the victim, "... you somehow think that it’s your right to suffer?" This is recommended listening for referring practitioners. Here is the world you are recommending patients to for care. The YouTube URL is http://www.youtube.com/watch?v=hcGtSzd9Tzo
Step 5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
AA’s most prolific contemporary critic, A. Orange, writes how this puts the inductee in the humiliating position of confessing to, preferably, their unqualified, ethically-unbound, accountability-free AA sponsor or another AA member, “every most intimate dirty little secret” of their entire life. This places them at risk of potential future personal exploitation and of the gratuitous malice of mentally unstable, disgruntled ex-sponsors (Orange.)
Ken Ragge, in The Real AA: The Myth Behind 12-Step Recovery, gives an analysis of the fourth and fifth steps as a bait-and-switch from the medical to the moral model: here the program takes the inductee through a fundamental paradigm switch. Earlier, the newcomer's problem was defined as a medical disease. Now "medical" is morphed into "moral" and the message is that the individual drank because of "defects of character." This immediately reloads the burden of guilt and shame that the medical disease theory might have discharged, and the individual now defines herself as a thoroughly bad and worthless person. Survival beyond this point is possible only through divine grace; redemption is attainable only by bringing in others to start the process anew (Ragge, 1998.)
Step 6. Were entirely ready to have God remove all these defects of character.
Paul A. Toth discusses Step 6 and ramifications for nationwide medical malpractice in referring a patient with a “medical” disease to a recovery program that requires supernatural removal of “moral character defects” (Toth). Here again, as in Step 4, AA’s main program texts state specifically, in Step 6, what is meant by character defects: “That is the measure of our character defects, or, if you wish, of our sins.” (12 & 12 p 65). And so again, the question presents itself: how does Australia’s government justify instruction of Intensive AA Referral, made by medical professionals bound by Hippocratic Oath, to a pseudoscientific quasi-religion which addresses alcohol disorders by praying for removal of sins?
Step 7. Humbly asked Him to remove our shortcomings.
Non-religious Australians told they can benefit from AA may take justifiable issue. This Step has its own essential prayer, “said in a humbling position”. Hoping to use a doorknob as a higher power, non-believers find this step particularly perplexing. 7th Step Prayer said aloud on bended knee to said doorknob: “My Creator, I am now willing that you should have all of me, good and bad. I pray that you now remove from me every single defect of character which stands in the way of my usefulness to you and my fellows. Grant me strength, as I go out from here, to do your bidding. Amen.” (Big Bookp76.)
Step 8. Made a list of all persons we had harmed, and became willing to make amends to them all. Step 9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
Excerpted from Ken Ragge’s The Real AA: Behind the Myth of 12-Step Recovery:
These Steps, like the others, mimic the spiritual principles of the world’s great religions. However, in AA “making amends,” elsewhere known as “atoning for one’s sins,” is also perverted. The major motivation for making amends in AA is not regret, but fear of drinking and dying. Also important is the promise of being “catapulted into the fourth dimension of existence” for “painstakingly” working the Steps.
This distorts the purpose behind acts of atonement. When a grouper makes amends, he isn’t necessarily sorry. Of course, any act he does regret will make the list of Step Eight and amends will be made in Step Nine. However, he also is likely to “make amends” he wouldn’t make if he valued his better judgment. In AA, if one’s better judgment does not agree with the elders, it is merely “one’s disease speaking.” It is wilfulness and self-centeredness.
This Step is often carried to ridiculous extremes. For example, one woman shared at a meeting that her sponsor had told her she must make amends in a situation where she had serious misgivings.
While alone in a ladies room, she was confronted by a man standing in front of her masturbating. Shocked and frightened, she screamed at him to get out. He didn’t blink. She screamed at him again. He still neither stopped nor left. Probably more out of panic than anything else, she hit him. Her sponsor told her that while what the man had done may have been wrong, it was her responsibility to “keep her own side of the street clean.” She needed to make amends to him. Her “sobriety” was at stake.
While this example may seem extreme, this woman’s plight is not unusual in AA. It is entirely consistent with AA’s view of the “alcoholic” as “bad child,” sinner or hopeless defective. Doubtless her sponsor saw, and she herself worried, that not wanting to make amends was a dangerous “manifestation of self.” She was humiliated by the exhibitionist. If she actually carried out “making amends” she would have felt humiliated again. In AA, “humiliation = humility.” It is a good emotion. (Ragge, 1998.)
Step 10. Continued to take personal inventory and when we were wrong promptly admitted it.
By Step 10 the inductee has learnt that recovery can only be possible when one puts one’s life in God’s hands. Even then, however, only a daily reprieve is all that is promised (“we are never cured of alcoholism”), contingent on daily prayer. Again, this Step has its own specific prayer. Non-believer on bended knee addresses light bulb: "How can I best serve Thee, Thy will (not mine) be done."
Step 11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
And another specifically worded, text-prescribed prayer to the doorknob: “Thy will be done.” (12&12 p103.) This Step renders the AA inductee reliant on divine guidance - which must be checked for legitimacy with her sponsor, who is more experienced and thought better able to determine whether the “guidance” received is authentic or a product of the inductee’s ‘early recovery’ imagination. The sponsor’s role here extends to correcting any imagined guidance of the novice, and re-instructing with “legitimate” divine guidance. And so the sponsor becomes God’s representative and interpreter. Usually spiritual guidance is given by priests, pastors, rabbis and religious leaders. The sponsor, however, is not a professionally educated spiritual director or pastoral counsellor. Many sponsors, all recovering addicts themselves, have co-dependency issues. Some also have mental health issues, diagnosed or undiagnosed, treated or untreated. Some may knowingly or unknowingly abuse this position of intimate trust and authority.
Step 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
This entails recruitment of new inductees (victims of an insidious and misleading indoctrination process becoming perpetrators). One defining word for “carrying the message” of God’s help is “evangelism”, which refers to the practice of relaying information about a particular set of beliefs to others who do not hold those beliefs. Another is proselytism, which describes the act of attempting to convert people to another opinion and, particularly, another religion. Neither has any remote connection to alcohol abuse disorder. Evangelism and proselytism are specifically religious, another example of this paper’s recurring point that government recommendations for Intensive Referral to AA for the non-religious, on unproven superior therapeutic grounds, are naive and misguided or dishonest and religiously coercive – particularly in cases when the client’s government welfare benefits (Sickness Allowance, Disability Support) are conditional to compliance with a recognised recovery strategy such as AA.
AA’s main program texts: background
Nicknamed after the Bible, AA’s Big Book states (p44) "we are told that alcoholism is an illness which only a spiritual experience will conquer." AA Co-founder Bill Wilson, a washed-up stockbroker and fanatical Oxford Group proselyte, as was his cohort, proctologist Dr Bob Smith, had his own “spiritual awakening” while hospitalised for acute chronic alcoholism. Enduring severe delirium tremens, or "spirit fingers", Wilson was first sedated with Towns Hospital’s regular cocktail of morphine, chloral hydrate and paraldehyde. Dr Silkworth then gave him the famous Towns-Lambert Belladonna Cure, a formula including deadly nightshade, known for causing hallucinations, light sensitivity, delirium and confusion. (Lee.) The mixture also included henbane, used for millennia in "magic brews." (Carter.) Its psychoactive effects include visual hallucinations and a sensation of flight. (Schultse & Smith.) Of this “spiritual experience” Wilson wrote:
"Suddenly my room blazed with an indescribably white light. I was seized with an ecstasy beyond description. Every joy I had known was pale by comparison." His interpretation of this as an intensely religious epiphany was further reinforced by his reading of William James' 1902 Varieties of Religious Experience, rich with examples of alcoholic conversion, in which James opined "the only cure for dipsomania is religiomania." (James) (Cheever)
Subsequently, despite claiming his program had restored sanity and made everyone happy, joyous and free, Wilson became chronically depressed for eleven years working his own program. Even after long term abstinence from alcohol, he experimented with other possible cures including necromancy and LSD, for his alcoholism, which he believed continues to progress, even in abstinence, needing lifelong address (Ragge) (Bufe) (Hartigan).
One of Wilson’s most thoroughly read (and unforgiving) profilers writes that he was “clinically diagnosably insane, suffering from 297.10 Delusional (Paranoid) Disorder, Grandiose Type and 301.81 Narcissistic Personality Disorder as defined by the American Psychiatric Association in The Diagnostic and Statistical Manual of Mental Disorders, third and fourth editions, DSM-III-R and DSM-IV. The bombastic, grandiose and delusional things that Wilson wrote in the Big Book and in Twelve Steps and Twelve Traditions leave little doubt about that. His behaviour, both before and after sobriety, leaves even less doubt. He was not a wise counsellor, but was grossly, feloniously dishonest, coldly exploitative of others and a grandiose, habitual liar.” (Orange)
Wilson projected his egocentric nature into AA’s main text as the prototype alcoholic personality, appealing to his flock to “look for the similarities”. AA devotees have striven to do this since 1939, ultimately taking on projected stock personality traits they never had prior to AA.
But like many charismatic figureheads, after forming his program of honesty and moral address for others, with its traditions of anonymity and avoidance of controversy, Wilson did not lead by example, for years basking in public acclaim while cheating on his wife and exploiting vulnerable female inductees. (Biographers Francis Hartigan, Matthew Raphael and Susan Cheever all cite claims of Wilson’s marital infidelity and promiscuity.) His own moral shortcomings and unmanaged compulsions created internal fellowship problems, noted by Cynthia Perkins M.Ed.: “Wilson had not discovered a cure for alcoholism or addiction, but had instead switched his addiction from alcoholism to sex, nicotine, caffeine, women and fanatic religious practices. Wilson was a sex addict who used his position of power in AA to take advantage of and use vulnerable women in the AA community. This behaviour was the cause of great controversy throughout AA, but was kept secret so that it wouldn't have a negative effect on the movement. It created a lot of conflict between him and other members as well as within himself.” (Perkins.)
Wilson also created legal problems concerning the Big Book copyright, which he stole from his founding brethren (Wilson was not the sole author and had originally agreed that the proceeds would be the group’s). This was sworn in the 1998 court attestation of Wilson’s Cofounder’s daughter. (Windows). Charles Bufe’s scholarly AA: Cult or Cure thoroughly references Wilson’s fiddling with funds earmarked for publication of the Big Book (Bufe). The royalties provided a lucrative money spinner for Wilson, previously unable to purchase clothing and dependent on others for a place to live. He died in 1971. The book provided luxury for his widow Lois, who inherited 90% of his estate (his favourite mistress Helen Wynn inherited 10%, but died a few years after Wilson) as AA membership grew to millions internationally and Big Book sales rocketed accordingly. President Richard Nixon received the millionth copy of the book. In 2005 the 25-millionth copy was presented at the International AA Convention. By December 2009 over 30 million copies had been sold, ranking it high on the list of best-selling books ever. When Lois passed away in 1988 her gross estate was nearly 4 million dollars (valued at 7.5m in 2011). Francis Hartigan, who was Lois’ private secretary, details this, substantiated by the probate records, in Bill W. A Biography of Alcoholics Anonymous Cofounder Bill Wilson. (Hartigan)
In keeping with his one-rule-for-all (except himself), despite promoting a lifetime of AA for alcoholics as the only solution, Wilson rarely attended AA meetings during the last years of his own life (Rapael). A heavy smoker, Wilson eventually suffered from emphysema. In the last days of his life he made demands for whiskey and became belligerent when refused (Cheever).
Wilson put his name to the Big Book in 1939 to make money for the development and growth of AA which, for four years, had operated under the name of the Oxford Groups of Akron and New York. Alcoholics Anonymous was the book’s title, and so the fledgling organisation renamed itself, breaking off from the Oxford Group. The Big Book provides AA’s earliest program outline in Wilson’s 12 Steps which, he claimed, were the method successfully used by AA’s legendary “First 100” members. In The Myth of the First 100, AA historian Jim F demonstrates, listing specific names and dates, how this was sheer spin doctoring: the 12 Steps were not composed and written down until that 1939 first edition of the Big Book. This “First 100” were not technically members of groups called AA (which didn’t exist in name) but of the Oxford Groups from 1935 until 1939 when they branched off and took the name AA. They had never heard of the 12 Steps. Nor did this legendary group comprise one hundred people - by 1939 the number was only in the low seventies. A.A.'s pioneers inflated the head count up to the nearest one-hundred. Of those, few stayed sober (F, Jim).
Francis Hartigan notes, “During Bill’s stay in Akron, he and Bob calculated their success rate to be about 5 percent, and among the few who seemed to catch on, not all of them were able to maintain consistent sobriety. The first edition of AA’s Big Book, published in 1939, contains the personal recovery stories of many of AA’s earliest members. Some years later, Bill made notations in the first copy of the book to come off the press, indicating which individuals portrayed therein had stayed sober. A good 50 percent of them had not.” (Hartigan.)
AA’s program, then, was codified from Oxford Group tenets by a mentally unstable, religious extremist entrepreneur, its initial claims of efficacy demonstrably false. Nevertheless, those relapsing early AA members believed the Big Book to have been divinely inspired, passing down the claim into AA folklore. AA’s conference-approved material documents Wilson’s composition of the 12 Steps thus: “As he started to write, he asked for guidance. And he relaxed. The words began tumbling out with astonishing speed.” (AA World Services, 1984.)
Convinced they were doing God’s work, AA networks spread Wilson’s word and, by 1940, his book reached people in high places, resulting in support money from John D. Rockefeller (Time Magazine, 1940). AA had its next lucky break the following year when, in March, 1941, an article entitled Alcoholics Anonymous by Jack Alexander appeared in the Saturday Evening Post, one of the America's most popular publications at that time. (Alexander.) AA’s success skyrocketed from there on, but that success was always of an entrepreneurial nature, never a therapeutic one, as remains the case 70 years later. So said psychologist Stanton Peele, named as one of the top ten addiction experts in America, recently: “AA's success is not one of clinical outcomes but of public relations and cultural appeal...as evidence of its success it relies on personal testimonies ....” (Peele.)
Indeed, AA is the biggest and the oldest (“time tested”). But the wheel that squeaks the loudest is not necessarily the best and is often the one that needs the most fixing, or indeed, replacing with a new wheel. The medical practice of blood-letting stood the “test of time” for nearly 1600 years - should Australian doctors Intensively Refer that?
AA’s other main working text is The Twelve Steps and Twelve Traditions. One reviewer, a classic example of someone personally damaged by Intensive Referral to a program unfitting to his belief system, describes 12 & 12 as: “One of the most insane and vicious books around. It is right down there with Mein Kampf as far as its ratio of lies to truth, and hate content is concerned. Ostensibly Bill Wilson's explanation of his Twelve Steps and Twelve Traditions, it is really something quite dark and evil, Bill Wilson's poisonous contempt for human nature masquerading as spirituality. It was written while Wilson was in the middle of his eleven-year-long bout of deep clinical depression, and it shows. It is a brutal, hateful assault on the character of people who happen to have a drinking problem. Bill Wilson hated himself and his own character flaws, so he projected all of his own weaknesses and character flaws onto the alcoholics around him, and onto a mythical stereotypical alcoholic, and then said, ‘Look at him. Look at how disgusting he is. We are all like that.’ This whole book is non-stop guilt induction.” (Orange.)
Nicknamed after the Bible, AA’s Big Book states (p44) "we are told that alcoholism is an illness which only a spiritual experience will conquer." AA Co-founder Bill Wilson, a washed-up stockbroker and fanatical Oxford Group proselyte, as was his cohort, proctologist Dr Bob Smith, had his own “spiritual awakening” while hospitalised for acute chronic alcoholism. Enduring severe delirium tremens, or "spirit fingers", Wilson was first sedated with Towns Hospital’s regular cocktail of morphine, chloral hydrate and paraldehyde. Dr Silkworth then gave him the famous Towns-Lambert Belladonna Cure, a formula including deadly nightshade, known for causing hallucinations, light sensitivity, delirium and confusion. (Lee.) The mixture also included henbane, used for millennia in "magic brews." (Carter.) Its psychoactive effects include visual hallucinations and a sensation of flight. (Schultse & Smith.) Of this “spiritual experience” Wilson wrote:
"Suddenly my room blazed with an indescribably white light. I was seized with an ecstasy beyond description. Every joy I had known was pale by comparison." His interpretation of this as an intensely religious epiphany was further reinforced by his reading of William James' 1902 Varieties of Religious Experience, rich with examples of alcoholic conversion, in which James opined "the only cure for dipsomania is religiomania." (James) (Cheever)
Subsequently, despite claiming his program had restored sanity and made everyone happy, joyous and free, Wilson became chronically depressed for eleven years working his own program. Even after long term abstinence from alcohol, he experimented with other possible cures including necromancy and LSD, for his alcoholism, which he believed continues to progress, even in abstinence, needing lifelong address (Ragge) (Bufe) (Hartigan).
One of Wilson’s most thoroughly read (and unforgiving) profilers writes that he was “clinically diagnosably insane, suffering from 297.10 Delusional (Paranoid) Disorder, Grandiose Type and 301.81 Narcissistic Personality Disorder as defined by the American Psychiatric Association in The Diagnostic and Statistical Manual of Mental Disorders, third and fourth editions, DSM-III-R and DSM-IV. The bombastic, grandiose and delusional things that Wilson wrote in the Big Book and in Twelve Steps and Twelve Traditions leave little doubt about that. His behaviour, both before and after sobriety, leaves even less doubt. He was not a wise counsellor, but was grossly, feloniously dishonest, coldly exploitative of others and a grandiose, habitual liar.” (Orange)
Wilson projected his egocentric nature into AA’s main text as the prototype alcoholic personality, appealing to his flock to “look for the similarities”. AA devotees have striven to do this since 1939, ultimately taking on projected stock personality traits they never had prior to AA.
But like many charismatic figureheads, after forming his program of honesty and moral address for others, with its traditions of anonymity and avoidance of controversy, Wilson did not lead by example, for years basking in public acclaim while cheating on his wife and exploiting vulnerable female inductees. (Biographers Francis Hartigan, Matthew Raphael and Susan Cheever all cite claims of Wilson’s marital infidelity and promiscuity.) His own moral shortcomings and unmanaged compulsions created internal fellowship problems, noted by Cynthia Perkins M.Ed.: “Wilson had not discovered a cure for alcoholism or addiction, but had instead switched his addiction from alcoholism to sex, nicotine, caffeine, women and fanatic religious practices. Wilson was a sex addict who used his position of power in AA to take advantage of and use vulnerable women in the AA community. This behaviour was the cause of great controversy throughout AA, but was kept secret so that it wouldn't have a negative effect on the movement. It created a lot of conflict between him and other members as well as within himself.” (Perkins.)
Wilson also created legal problems concerning the Big Book copyright, which he stole from his founding brethren (Wilson was not the sole author and had originally agreed that the proceeds would be the group’s). This was sworn in the 1998 court attestation of Wilson’s Cofounder’s daughter. (Windows). Charles Bufe’s scholarly AA: Cult or Cure thoroughly references Wilson’s fiddling with funds earmarked for publication of the Big Book (Bufe). The royalties provided a lucrative money spinner for Wilson, previously unable to purchase clothing and dependent on others for a place to live. He died in 1971. The book provided luxury for his widow Lois, who inherited 90% of his estate (his favourite mistress Helen Wynn inherited 10%, but died a few years after Wilson) as AA membership grew to millions internationally and Big Book sales rocketed accordingly. President Richard Nixon received the millionth copy of the book. In 2005 the 25-millionth copy was presented at the International AA Convention. By December 2009 over 30 million copies had been sold, ranking it high on the list of best-selling books ever. When Lois passed away in 1988 her gross estate was nearly 4 million dollars (valued at 7.5m in 2011). Francis Hartigan, who was Lois’ private secretary, details this, substantiated by the probate records, in Bill W. A Biography of Alcoholics Anonymous Cofounder Bill Wilson. (Hartigan)
In keeping with his one-rule-for-all (except himself), despite promoting a lifetime of AA for alcoholics as the only solution, Wilson rarely attended AA meetings during the last years of his own life (Rapael). A heavy smoker, Wilson eventually suffered from emphysema. In the last days of his life he made demands for whiskey and became belligerent when refused (Cheever).
Wilson put his name to the Big Book in 1939 to make money for the development and growth of AA which, for four years, had operated under the name of the Oxford Groups of Akron and New York. Alcoholics Anonymous was the book’s title, and so the fledgling organisation renamed itself, breaking off from the Oxford Group. The Big Book provides AA’s earliest program outline in Wilson’s 12 Steps which, he claimed, were the method successfully used by AA’s legendary “First 100” members. In The Myth of the First 100, AA historian Jim F demonstrates, listing specific names and dates, how this was sheer spin doctoring: the 12 Steps were not composed and written down until that 1939 first edition of the Big Book. This “First 100” were not technically members of groups called AA (which didn’t exist in name) but of the Oxford Groups from 1935 until 1939 when they branched off and took the name AA. They had never heard of the 12 Steps. Nor did this legendary group comprise one hundred people - by 1939 the number was only in the low seventies. A.A.'s pioneers inflated the head count up to the nearest one-hundred. Of those, few stayed sober (F, Jim).
Francis Hartigan notes, “During Bill’s stay in Akron, he and Bob calculated their success rate to be about 5 percent, and among the few who seemed to catch on, not all of them were able to maintain consistent sobriety. The first edition of AA’s Big Book, published in 1939, contains the personal recovery stories of many of AA’s earliest members. Some years later, Bill made notations in the first copy of the book to come off the press, indicating which individuals portrayed therein had stayed sober. A good 50 percent of them had not.” (Hartigan.)
AA’s program, then, was codified from Oxford Group tenets by a mentally unstable, religious extremist entrepreneur, its initial claims of efficacy demonstrably false. Nevertheless, those relapsing early AA members believed the Big Book to have been divinely inspired, passing down the claim into AA folklore. AA’s conference-approved material documents Wilson’s composition of the 12 Steps thus: “As he started to write, he asked for guidance. And he relaxed. The words began tumbling out with astonishing speed.” (AA World Services, 1984.)
Convinced they were doing God’s work, AA networks spread Wilson’s word and, by 1940, his book reached people in high places, resulting in support money from John D. Rockefeller (Time Magazine, 1940). AA had its next lucky break the following year when, in March, 1941, an article entitled Alcoholics Anonymous by Jack Alexander appeared in the Saturday Evening Post, one of the America's most popular publications at that time. (Alexander.) AA’s success skyrocketed from there on, but that success was always of an entrepreneurial nature, never a therapeutic one, as remains the case 70 years later. So said psychologist Stanton Peele, named as one of the top ten addiction experts in America, recently: “AA's success is not one of clinical outcomes but of public relations and cultural appeal...as evidence of its success it relies on personal testimonies ....” (Peele.)
Indeed, AA is the biggest and the oldest (“time tested”). But the wheel that squeaks the loudest is not necessarily the best and is often the one that needs the most fixing, or indeed, replacing with a new wheel. The medical practice of blood-letting stood the “test of time” for nearly 1600 years - should Australian doctors Intensively Refer that?
AA’s other main working text is The Twelve Steps and Twelve Traditions. One reviewer, a classic example of someone personally damaged by Intensive Referral to a program unfitting to his belief system, describes 12 & 12 as: “One of the most insane and vicious books around. It is right down there with Mein Kampf as far as its ratio of lies to truth, and hate content is concerned. Ostensibly Bill Wilson's explanation of his Twelve Steps and Twelve Traditions, it is really something quite dark and evil, Bill Wilson's poisonous contempt for human nature masquerading as spirituality. It was written while Wilson was in the middle of his eleven-year-long bout of deep clinical depression, and it shows. It is a brutal, hateful assault on the character of people who happen to have a drinking problem. Bill Wilson hated himself and his own character flaws, so he projected all of his own weaknesses and character flaws onto the alcoholics around him, and onto a mythical stereotypical alcoholic, and then said, ‘Look at him. Look at how disgusting he is. We are all like that.’ This whole book is non-stop guilt induction.” (Orange.)
Indoctrination of AA newcomers
Instructions in AA’s material are to feed newcomers the truth about the program by “teaspoons, rather than by buckets” (Alcoholics Anonymous Comes of Age, page 75). The Big Book says that this is because "we need not, and probably should not emphasize the spiritual feature on our first approach. We might prejudice them" (p76-77). AA’s shame-based, fear-based, guilt-inducing program is described, at first glance of its text, only as a “suggested program of recovery.” Read aloud at the start of every meeting, AA’s Preamble assures, “the only requirement for membership is a desire to stop drinking.” Newcomers at meetings hear the common AA catchcry “take what you want and leave the rest” from the floor by old timers. Yet confusingly, at every meeting’s half-time reading aloud of How It Works, these same newcomers hear this Big Book passage: “Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are those who cannot or will not give themselves completely to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.”
This might ring alarm bells were most AA newcomers not lost in a fog of despair to get well. Alone and outnumbered amongst indoctrinated strangers whose help they need, most raise no outward objection to this convoluted (and completely untrue) jargon. Non-sufferers, with more clarity, have gained clearer insights to the above quoted passage: “Terribly judgemental!” remarked Dr James Bell in one Sydney media interview. Bell is a Sydney physician specialising in addiction and former director of Sydney’s Langton Centre. “That’s like saying, ‘If you’re a loser, it won’t work for you’. Despite the design of AA – the belief that alcoholism is a disease – there remains this spectre of, ‘You’re getting this one chance and, if you don’t take it, then you’re basically a very flawed person with some serious character defects.’” (Marx.)
Bell said further of AA, “It’s an evangelical movement about saving souls. But AA is not a treatment and shouldn’t be regarded as anything to do with treatment. It tends to be very confronting: ‘I can do it, therefore you can do it.’ In a lot of people that actually generates some antagonism and feelings of failure. It confirms their badness for them. The approach that most professionals would argue is more appropriate is a much more accepting, non-judgmental approach whereby one works with someone to try and find out what’s going on, rather than to set up two black and white alternatives.”
Bell added, “Like many evangelical movements, AA has become a victim of its own excesses in terms of fundamentalism. And fundamentalism is a narrow church, a church of blacks and whites. Of course, life is full of greys and soft edges and tolerance and forbearance and humour, all of which are conspicuously lacking in a world of fundamentalist zeal.”
And so, these vulnerable Australian sufferers, assured by their government via their GPs or therapists that “a common misconception concerning 12 step groups is that members need to be religious to benefit from the program,” are lead, like lambs to the slaughter.
Soon into indoctrination (a brainwashing, socially marginalising 90 meetings in 90 days) the newly-labelled “alcoholic” is considered inducted. This is when, sharing in meetings, confessions of ongoing reluctance towards AA’s religiosity start to result in the inductee receiving cross-shared rebuttals to “get off the fence and get with the program”. Those clinging to agnosticism are sharply referred to the Big Book’s Chapter to the Agnostics, where they find their theosophical ilk the targets of ad hominem attacks for being “dishonest”. They are told to “Get with God”. Two Canadian “Agnostic AA” groups hit news headlines in 2011 after AA delisted them for “dropping God”. (Scrivener.)
And possibly around this point, the inductee encounters AA’s cultic death threat, which states in no uncertain terms that “unless each A.A. member follows to the best of his ability our suggested Twelve Steps to recovery, he almost certainly signs his own death warrant.”(12 & 12 p174.)
12-Step Groupspeak: “Our only hope without 12-step life is jails, institutions, and death.”
Instructed by the texts to “give yourself completely” to AA’s program and to trust in the program “with complete abandon” the inductee has already been taught to believe she is insane (Step 2) and unable to rely on her own thinking. She is now told, repetitively, in front of the group, like every one of her recently indoctrinated peers, “Your best thinking got you here.” There is simply no AA graduation date, and so begins a coerced lifelong dependency upon AA, as the inductee is confronted with the “fact” that she is “doomed to an alcoholic death or to live on a spiritual basis.” (Big Book p 44.) She will learn that she will die without AA.
She may never presume, in AA, to take credit for her accomplishment of getting and staying sober, which is due only to the grace of God and AA. She may therefore never enjoy the sense of self-efficacy that some academics reason to be theoretically achievable, e.g. “several studies have also suggested that AA facilitated abstinence is partly due to an increase in self-efficacy that arises from its recovery.” (Proud et al, 2009.)
She may never devote much planning to a fulfilling future life – she must live and think only one day at a time and is sober only one day at a time. Abstinence without working her AA program is not “sobriety” but “dry drunk”. If she dares to leave AA and remains abstinent, many ex-AA peers will shun her as having never been a “true alcoholic”, otherwise only AA could have kept her sober. If she does leave but then returns having relapsed, broken and beaten down, she risks whatever random assortment is present, possibly walking into an icy wall of disdain and schadenfreude from those too afraid to leave themselves; rows of scowling, granite-faced oldtimers with pursed lips, frowns deeper than her own rock bottom and the condemning eyes of hanging-judges, furious after a lifetime of self-torture in AA. Such can be the contradiction of “the loving arms of AA” even in 2011.
She will face strong fellowship expectations to belong to a “home group” along with strong group expectations to devote her time and energy to “AA Service” work. This may take a large chunk out of her weekly schedule, leaving little time for social, family or existing intimate relationships or activities outside of AA. (This, along with any initial rehab isolation with none but AA conference-approved reading materials, compulsory inpatient AA meetings and the infamous “90 meeting in 90 days” fellowship induction protocol, has been recognised by cult experts as milieu control and family substitution). She will certainly learn that forming new intimate relationships are strictly opposed during the first year of AA recovery, “leave your old ways behind, and your old company. Only we understand you.” Erstwhile stable marriages often falter from this advice.
At the homegroup meeting, critical thinking is railed against, with rational questioning of the program considered a “disease symptom”, a deviance and a breach of several of AA’s Twelve Traditions, which ensure a code of silence on open criticism of AA’s program. Dissecting and deconstructing AA publicly from the floor is in contravention of the Fifth Tradition: “Each group has but one primary purpose - to carry its message to the alcoholic who still suffers.” (This acts to prevent scaring away newcomers by letting them hear too much too soon).
Backing up this code of silence is AA’s First Tradition, also effectively used to blockade open expression of discontent at meetings: “Our common welfare should come first; personal recovery depends upon A.A. unity.” Powerless and devoid of avenues for redress, members find there is no one in charge to turn to anyway - AA’s Second Tradition stares down, authoritatively from the wall banners: “For our group purpose there is but one ultimate authority - a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.” Leaderless organisations can never be changed because nobody is authorised to change them. Co-founder and Big Book copyright holder Wilson was the only individual in any position to update AA’s text-specific program. Even when this was logistically feasible, Wilson wrote in a letter to fellow AA Charles W, 3 June 1952:"As to changing the Steps themselves, or even the text of the A.A. book, I am assured by many that I could certainly be excommunicated if a word were touched. It is a strange fact of human nature that when a spiritually centered movement starts and finally adopts certain principles, these finally freeze absolutely solid.” (Kurtz.)
A recognised leaderless starfish organisation, AA has been compared to other absolutist fundamentalist creeds, such as Al Qaeda. Rod Beckstrom, Director of the National Cybersecurity Center at the U.S. Department of Homeland Security and pre-eminent world speaker on cybersecurity and related global issues, is the author of The Starfish and the Spider (Unstoppable Power of Leaderless Organizations), translated into 16 foreign editions. Beckstrom writes: “Starfish organisations tend to organise around a shared ideology or a simple platform for communication - around ideologies like Al Qaeda or Alcoholics Anonymous. Cut off the leg of a spider, and you have a seven-legged creature on your hands; cut off its head and you have a dead spider. But cut off the arm of a starfish and it will grow a new one. Not only that, but the severed arm can grow an entirely new body. Starfish can achieve this feat because, unlike spiders, they are decentralised; every major organ is replicated across each arm. So in today’s world Starfish organisations are starting to gain the upper hand.” (Beckstrom.)
Meanwhile, back at her homegroup, sharing that she has not the same intrinsic prototype alcoholic personality traits of AA’s 1895-born stockbroking male co-founder Bill Wilson, our novice risks gang derision - she is “in denial”. Denying denial is futile, as this is seen as further denial. She can choose to conform for group acceptance and wear the projected new defective personality, or face ostracism – cancelling out the case in favour of AA group support. Desperate to achieve prolonged abstinence, she will now surrender either her ego or integrity and conform. Like so many criminals entering the penal system only to learn more crime, the AA inductee will learn to be “an alcoholic” as per the book. She will, in only a matter of time, have adopted an entirely new set of personality traits that she must “work on” quite unnecessarily, every day for the rest of her life. Every normal, human negative thought or feeling she encounters, she will be trained to interpret as a “disease symptom”. She will spend the rest of her life taking moral inventory and struggling, in vain, to pray away her primary personality and her ego.
She must succumb to AA’s requirement of rewriting her past. David Rudy, author of Becoming Alcoholic: Alcoholics Anonymous and the Reality of Alcoholism, became a participant-observer, attending AA meetings and observing how members became moulded into AA-alcoholics. Whatever their drinking concerns or problems initially, all members soon learned through reward and punishment to adopt AA’s symptoms of alcoholism. When newcomers said they didn't recall if they had ever blacked out, they were told, “Of course, because you don't remember black outs!” (Rudy)
Such a life, for many, is one not of serenity, but of frustration, anxiety, depression or anger, all triggers for relapse. Australia’s Review of the Evidence notes that “specific situations or mood states are associated with relapse, including negative emotional states e.g. frustration, anxiety, depression or anger (Marlatt and Gordon 1985).” (Proude, et al.)
Marianne Gilliam, author of How Alcoholics Anonymous Failed Me, discusses problems with 12-step programs clearly and rationally. The Book Talk review (by people in recovery) says: "This book is worthy of notice because the author shares AA's core view that the way out lies through a spiritual conversion experience. Yet, no matter how hard she tried, Gilliam could not find in the AA environment the spiritual fulfilment she sought. This may suggest that AA has become so wooden in its dogma and arrogant in its power, like a church that got too rich, that there is no genuine spirituality left in it. For her, the programs are fear-based (fear of drinking/using again, fear of this ‘cunning, baffling disease’, fear of not working the steps properly). She likens 12-step programs to Christianity and the parent-child relationship - looking for something outside ourselves for help and guidance, rather than looking within. This is also evident in the sponsor-sponsee relationship where the sponsee is always in a subservient position, never reaching equality with one's sponsor. Instead of dealing with her emotions and cravings, Gilliam’s sponsor dealt her orders and slogans - go to more meetings, do a fourth step, ‘Let Go and Let God’. She also realised that when taking a ‘moral inventory’, the only items had to be shortcomings, character flaws, and moral defects - no room for any positives. It all added up to a program that left her fearful, dominated by others, powerless, and seeking outside validation.” (Book Talk)
Gilliam’s book is introduced by award-winning psychologist Charlotte Davis Kasl Ph.D, author of Many Roads, One Journey: Moving Beyond the 12 Steps. Kasl’s own book, focussing especially on recovery from the female AA member’s viewpoint, covers how society has changed since the formation of AA in 1935, the issues of the narcissism inherent in AA and the rigidity with which groups and individuals practice the program – how, AA’s "spiritual" program frequently becomes a religious one, with dominant members’ beliefs approaching fundamentalist proportions, deterring non-fundamentalist attempts to participate. (Kasl.) Her noted characteristics of unhealthy groups include:
Kasl’s observation on AA groups as havens for sexual predators is no isolated one. "Thirteenth-stepping", a disparaging AA euphemism referring to sexual exploitation of vulnerable newcomers, has been documented in professional journals. (Bogart & Pearce.) This is as much an Australian issue, which received special attention, along with financial and spiritual predators at meetings, at our 2001 Regional Forum, resulting in a members notice, Dealing With Predators - still online ten years later. (General Service Board, AA Australia).
The fellowship of AA becomes the replacement social network, with links to old social networks, friendships and family ties often frowned upon and discouraged. Under cover researchers Alexander and Rollins recorded one member advising them, “You have to cut off from your family and turn them over to God." Non-AA outsiders are called “Normies”. (Alexander & Rollins.)
In AA, forms of professional “outside help” are rampantly talked-down from the inside, despite the official AA disclaimer on this to keep up appearances. As one zealous member shared in this author’s presence, “Psychology and pharmacology are only knowledge. We need supernatural help for our condition.” This ideology emanates from AA’s main texts, which teach that alcoholism is a malady “which no human power can overcome.”
Many a tortured bipolar, depression or schizophrenia sufferer has shared at a meeting of having been instructed by his sponsor to substitute his lithium, SRIs or other such vital medication, for prayer and meetings. A significant vocal anti-medication faction within AA aggressively undermines the medical advice of newcomers, who are told that they “aren’t really sober” if they take medication. Some go off of it with disastrous results. AA Australia’s National Office found this issue pressing enough to request a members’ memo from Class A Trustee Dr Vanda Rounsenfell, which is currently online here. Dr Rosenfell notes that this is “an old concern in AA but it still happens.” She discusses reports of “suicide, serious damage to personal confidence and psychotic breakdown.” (Rounsenfell.)
A 2000 study called Alcoholics Anonymous and the Use of Medications to Prevent Relapse: An Anonymous Survey of Member Attitudes systematically assessed AA members anonymously about their attitudes toward use of medication for preventing relapse and their experiences with medication use of any type in AA. 29% reported personally experiencing some pressure to stop a medication (of any type). It found that a need exists to integrate medication within the philosophy of 12-step treatment programs (Rychtarik, et al.)
Consider a person requiring treatment for schizophrenia being told that if they just handed their will over to the care of God as Bill Wilson understood him in the 1930’s, their problem would be solved. And, as NDRAC has established, 42 per cent of Australians with alcohol problems have at least one co-existing mental illness. (NDARC, 2010.)
In accordance with AA’s Eighth Tradition, “Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers”, AA sponsors are untrained, unqualified fellow-alcoholics. They operate under no accountability or control standards of any kind, some inevitably affected by mental health conditions, either diagnosed or undiagnosed, managed or not. Sponsorship is primarily aimed at denigrating and controlling newcomers. Many AA sponsors are drawn to this pastime in the absence of fulfilling life purpose, such as employment or a life partner. As recovering alcoholics and long-term AA members, sponsors may be permanently disenfranchised from their families of origin. Thus sponsor/sponsee relationships can become intense, raising long term co-dependence issues. Some sponsors are renowned for breaking up marriages and families, and have made world news in recent years after sexually exploiting vulnerable newcomers (Fisher, M), as any quick internet search will confirm with recent media news reports. (Just Google search “Alcoholics Anonymous accused”.)
Evidence shows that having a sponsor is non-beneficial. Published 2002 findings indicated that having a sponsor in NA/AA was not associated with any improvement in 1-year sustained abstinence rates than a non-sponsored group. However, being a sponsor over the same time period was strongly associated with substantial improvements in sustained abstinence rates for the sponsors. So sponsorship is only to the sponsor’s advantage, not the sponsee’s (Crape, et al.)
One’s sponsor, nevertheless, becomes one’s life-coach and mentor. It’s luck-of the-draw as to just how sane and functional, controlling and unbalanced, knowledgeable or ill advising she or he will turn out to be in the fullness of time. Anecdotal evidence is rife of resentful, compulsive ex-sponsors harassing, even stalking, members who chose to leave AA. Should they later feel the need to return, however, deserters are seen as apostates and are often shunned and demeaned as such, overtly or insidiously.
Instructions in AA’s material are to feed newcomers the truth about the program by “teaspoons, rather than by buckets” (Alcoholics Anonymous Comes of Age, page 75). The Big Book says that this is because "we need not, and probably should not emphasize the spiritual feature on our first approach. We might prejudice them" (p76-77). AA’s shame-based, fear-based, guilt-inducing program is described, at first glance of its text, only as a “suggested program of recovery.” Read aloud at the start of every meeting, AA’s Preamble assures, “the only requirement for membership is a desire to stop drinking.” Newcomers at meetings hear the common AA catchcry “take what you want and leave the rest” from the floor by old timers. Yet confusingly, at every meeting’s half-time reading aloud of How It Works, these same newcomers hear this Big Book passage: “Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are those who cannot or will not give themselves completely to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.”
This might ring alarm bells were most AA newcomers not lost in a fog of despair to get well. Alone and outnumbered amongst indoctrinated strangers whose help they need, most raise no outward objection to this convoluted (and completely untrue) jargon. Non-sufferers, with more clarity, have gained clearer insights to the above quoted passage: “Terribly judgemental!” remarked Dr James Bell in one Sydney media interview. Bell is a Sydney physician specialising in addiction and former director of Sydney’s Langton Centre. “That’s like saying, ‘If you’re a loser, it won’t work for you’. Despite the design of AA – the belief that alcoholism is a disease – there remains this spectre of, ‘You’re getting this one chance and, if you don’t take it, then you’re basically a very flawed person with some serious character defects.’” (Marx.)
Bell said further of AA, “It’s an evangelical movement about saving souls. But AA is not a treatment and shouldn’t be regarded as anything to do with treatment. It tends to be very confronting: ‘I can do it, therefore you can do it.’ In a lot of people that actually generates some antagonism and feelings of failure. It confirms their badness for them. The approach that most professionals would argue is more appropriate is a much more accepting, non-judgmental approach whereby one works with someone to try and find out what’s going on, rather than to set up two black and white alternatives.”
Bell added, “Like many evangelical movements, AA has become a victim of its own excesses in terms of fundamentalism. And fundamentalism is a narrow church, a church of blacks and whites. Of course, life is full of greys and soft edges and tolerance and forbearance and humour, all of which are conspicuously lacking in a world of fundamentalist zeal.”
And so, these vulnerable Australian sufferers, assured by their government via their GPs or therapists that “a common misconception concerning 12 step groups is that members need to be religious to benefit from the program,” are lead, like lambs to the slaughter.
Soon into indoctrination (a brainwashing, socially marginalising 90 meetings in 90 days) the newly-labelled “alcoholic” is considered inducted. This is when, sharing in meetings, confessions of ongoing reluctance towards AA’s religiosity start to result in the inductee receiving cross-shared rebuttals to “get off the fence and get with the program”. Those clinging to agnosticism are sharply referred to the Big Book’s Chapter to the Agnostics, where they find their theosophical ilk the targets of ad hominem attacks for being “dishonest”. They are told to “Get with God”. Two Canadian “Agnostic AA” groups hit news headlines in 2011 after AA delisted them for “dropping God”. (Scrivener.)
And possibly around this point, the inductee encounters AA’s cultic death threat, which states in no uncertain terms that “unless each A.A. member follows to the best of his ability our suggested Twelve Steps to recovery, he almost certainly signs his own death warrant.”(12 & 12 p174.)
12-Step Groupspeak: “Our only hope without 12-step life is jails, institutions, and death.”
Instructed by the texts to “give yourself completely” to AA’s program and to trust in the program “with complete abandon” the inductee has already been taught to believe she is insane (Step 2) and unable to rely on her own thinking. She is now told, repetitively, in front of the group, like every one of her recently indoctrinated peers, “Your best thinking got you here.” There is simply no AA graduation date, and so begins a coerced lifelong dependency upon AA, as the inductee is confronted with the “fact” that she is “doomed to an alcoholic death or to live on a spiritual basis.” (Big Book p 44.) She will learn that she will die without AA.
She may never presume, in AA, to take credit for her accomplishment of getting and staying sober, which is due only to the grace of God and AA. She may therefore never enjoy the sense of self-efficacy that some academics reason to be theoretically achievable, e.g. “several studies have also suggested that AA facilitated abstinence is partly due to an increase in self-efficacy that arises from its recovery.” (Proud et al, 2009.)
She may never devote much planning to a fulfilling future life – she must live and think only one day at a time and is sober only one day at a time. Abstinence without working her AA program is not “sobriety” but “dry drunk”. If she dares to leave AA and remains abstinent, many ex-AA peers will shun her as having never been a “true alcoholic”, otherwise only AA could have kept her sober. If she does leave but then returns having relapsed, broken and beaten down, she risks whatever random assortment is present, possibly walking into an icy wall of disdain and schadenfreude from those too afraid to leave themselves; rows of scowling, granite-faced oldtimers with pursed lips, frowns deeper than her own rock bottom and the condemning eyes of hanging-judges, furious after a lifetime of self-torture in AA. Such can be the contradiction of “the loving arms of AA” even in 2011.
She will face strong fellowship expectations to belong to a “home group” along with strong group expectations to devote her time and energy to “AA Service” work. This may take a large chunk out of her weekly schedule, leaving little time for social, family or existing intimate relationships or activities outside of AA. (This, along with any initial rehab isolation with none but AA conference-approved reading materials, compulsory inpatient AA meetings and the infamous “90 meeting in 90 days” fellowship induction protocol, has been recognised by cult experts as milieu control and family substitution). She will certainly learn that forming new intimate relationships are strictly opposed during the first year of AA recovery, “leave your old ways behind, and your old company. Only we understand you.” Erstwhile stable marriages often falter from this advice.
At the homegroup meeting, critical thinking is railed against, with rational questioning of the program considered a “disease symptom”, a deviance and a breach of several of AA’s Twelve Traditions, which ensure a code of silence on open criticism of AA’s program. Dissecting and deconstructing AA publicly from the floor is in contravention of the Fifth Tradition: “Each group has but one primary purpose - to carry its message to the alcoholic who still suffers.” (This acts to prevent scaring away newcomers by letting them hear too much too soon).
Backing up this code of silence is AA’s First Tradition, also effectively used to blockade open expression of discontent at meetings: “Our common welfare should come first; personal recovery depends upon A.A. unity.” Powerless and devoid of avenues for redress, members find there is no one in charge to turn to anyway - AA’s Second Tradition stares down, authoritatively from the wall banners: “For our group purpose there is but one ultimate authority - a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.” Leaderless organisations can never be changed because nobody is authorised to change them. Co-founder and Big Book copyright holder Wilson was the only individual in any position to update AA’s text-specific program. Even when this was logistically feasible, Wilson wrote in a letter to fellow AA Charles W, 3 June 1952:"As to changing the Steps themselves, or even the text of the A.A. book, I am assured by many that I could certainly be excommunicated if a word were touched. It is a strange fact of human nature that when a spiritually centered movement starts and finally adopts certain principles, these finally freeze absolutely solid.” (Kurtz.)
A recognised leaderless starfish organisation, AA has been compared to other absolutist fundamentalist creeds, such as Al Qaeda. Rod Beckstrom, Director of the National Cybersecurity Center at the U.S. Department of Homeland Security and pre-eminent world speaker on cybersecurity and related global issues, is the author of The Starfish and the Spider (Unstoppable Power of Leaderless Organizations), translated into 16 foreign editions. Beckstrom writes: “Starfish organisations tend to organise around a shared ideology or a simple platform for communication - around ideologies like Al Qaeda or Alcoholics Anonymous. Cut off the leg of a spider, and you have a seven-legged creature on your hands; cut off its head and you have a dead spider. But cut off the arm of a starfish and it will grow a new one. Not only that, but the severed arm can grow an entirely new body. Starfish can achieve this feat because, unlike spiders, they are decentralised; every major organ is replicated across each arm. So in today’s world Starfish organisations are starting to gain the upper hand.” (Beckstrom.)
Meanwhile, back at her homegroup, sharing that she has not the same intrinsic prototype alcoholic personality traits of AA’s 1895-born stockbroking male co-founder Bill Wilson, our novice risks gang derision - she is “in denial”. Denying denial is futile, as this is seen as further denial. She can choose to conform for group acceptance and wear the projected new defective personality, or face ostracism – cancelling out the case in favour of AA group support. Desperate to achieve prolonged abstinence, she will now surrender either her ego or integrity and conform. Like so many criminals entering the penal system only to learn more crime, the AA inductee will learn to be “an alcoholic” as per the book. She will, in only a matter of time, have adopted an entirely new set of personality traits that she must “work on” quite unnecessarily, every day for the rest of her life. Every normal, human negative thought or feeling she encounters, she will be trained to interpret as a “disease symptom”. She will spend the rest of her life taking moral inventory and struggling, in vain, to pray away her primary personality and her ego.
She must succumb to AA’s requirement of rewriting her past. David Rudy, author of Becoming Alcoholic: Alcoholics Anonymous and the Reality of Alcoholism, became a participant-observer, attending AA meetings and observing how members became moulded into AA-alcoholics. Whatever their drinking concerns or problems initially, all members soon learned through reward and punishment to adopt AA’s symptoms of alcoholism. When newcomers said they didn't recall if they had ever blacked out, they were told, “Of course, because you don't remember black outs!” (Rudy)
Such a life, for many, is one not of serenity, but of frustration, anxiety, depression or anger, all triggers for relapse. Australia’s Review of the Evidence notes that “specific situations or mood states are associated with relapse, including negative emotional states e.g. frustration, anxiety, depression or anger (Marlatt and Gordon 1985).” (Proude, et al.)
Marianne Gilliam, author of How Alcoholics Anonymous Failed Me, discusses problems with 12-step programs clearly and rationally. The Book Talk review (by people in recovery) says: "This book is worthy of notice because the author shares AA's core view that the way out lies through a spiritual conversion experience. Yet, no matter how hard she tried, Gilliam could not find in the AA environment the spiritual fulfilment she sought. This may suggest that AA has become so wooden in its dogma and arrogant in its power, like a church that got too rich, that there is no genuine spirituality left in it. For her, the programs are fear-based (fear of drinking/using again, fear of this ‘cunning, baffling disease’, fear of not working the steps properly). She likens 12-step programs to Christianity and the parent-child relationship - looking for something outside ourselves for help and guidance, rather than looking within. This is also evident in the sponsor-sponsee relationship where the sponsee is always in a subservient position, never reaching equality with one's sponsor. Instead of dealing with her emotions and cravings, Gilliam’s sponsor dealt her orders and slogans - go to more meetings, do a fourth step, ‘Let Go and Let God’. She also realised that when taking a ‘moral inventory’, the only items had to be shortcomings, character flaws, and moral defects - no room for any positives. It all added up to a program that left her fearful, dominated by others, powerless, and seeking outside validation.” (Book Talk)
Gilliam’s book is introduced by award-winning psychologist Charlotte Davis Kasl Ph.D, author of Many Roads, One Journey: Moving Beyond the 12 Steps. Kasl’s own book, focussing especially on recovery from the female AA member’s viewpoint, covers how society has changed since the formation of AA in 1935, the issues of the narcissism inherent in AA and the rigidity with which groups and individuals practice the program – how, AA’s "spiritual" program frequently becomes a religious one, with dominant members’ beliefs approaching fundamentalist proportions, deterring non-fundamentalist attempts to participate. (Kasl.) Her noted characteristics of unhealthy groups include:
- The group discourages or blocks outside involvement.
- The group limits or discourages access to reading material or other forms of personal growth.
- Expression of dissension is punished, squelched, or strongly discouraged.
- The group becomes grandiose in its self-definition — "Ours is the one way, the road to salvation."
- Members become locked into stereotyped roles.
- The group becomes paranoid about outsiders or those who question the norm.
- Members begin to speak robotically.
- In-group jargon predominates in conversations.
- The group exerts pressure on people to stay.
- Members use the group for sexual needs.
Kasl’s observation on AA groups as havens for sexual predators is no isolated one. "Thirteenth-stepping", a disparaging AA euphemism referring to sexual exploitation of vulnerable newcomers, has been documented in professional journals. (Bogart & Pearce.) This is as much an Australian issue, which received special attention, along with financial and spiritual predators at meetings, at our 2001 Regional Forum, resulting in a members notice, Dealing With Predators - still online ten years later. (General Service Board, AA Australia).
The fellowship of AA becomes the replacement social network, with links to old social networks, friendships and family ties often frowned upon and discouraged. Under cover researchers Alexander and Rollins recorded one member advising them, “You have to cut off from your family and turn them over to God." Non-AA outsiders are called “Normies”. (Alexander & Rollins.)
In AA, forms of professional “outside help” are rampantly talked-down from the inside, despite the official AA disclaimer on this to keep up appearances. As one zealous member shared in this author’s presence, “Psychology and pharmacology are only knowledge. We need supernatural help for our condition.” This ideology emanates from AA’s main texts, which teach that alcoholism is a malady “which no human power can overcome.”
Many a tortured bipolar, depression or schizophrenia sufferer has shared at a meeting of having been instructed by his sponsor to substitute his lithium, SRIs or other such vital medication, for prayer and meetings. A significant vocal anti-medication faction within AA aggressively undermines the medical advice of newcomers, who are told that they “aren’t really sober” if they take medication. Some go off of it with disastrous results. AA Australia’s National Office found this issue pressing enough to request a members’ memo from Class A Trustee Dr Vanda Rounsenfell, which is currently online here. Dr Rosenfell notes that this is “an old concern in AA but it still happens.” She discusses reports of “suicide, serious damage to personal confidence and psychotic breakdown.” (Rounsenfell.)
A 2000 study called Alcoholics Anonymous and the Use of Medications to Prevent Relapse: An Anonymous Survey of Member Attitudes systematically assessed AA members anonymously about their attitudes toward use of medication for preventing relapse and their experiences with medication use of any type in AA. 29% reported personally experiencing some pressure to stop a medication (of any type). It found that a need exists to integrate medication within the philosophy of 12-step treatment programs (Rychtarik, et al.)
Consider a person requiring treatment for schizophrenia being told that if they just handed their will over to the care of God as Bill Wilson understood him in the 1930’s, their problem would be solved. And, as NDRAC has established, 42 per cent of Australians with alcohol problems have at least one co-existing mental illness. (NDARC, 2010.)
In accordance with AA’s Eighth Tradition, “Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers”, AA sponsors are untrained, unqualified fellow-alcoholics. They operate under no accountability or control standards of any kind, some inevitably affected by mental health conditions, either diagnosed or undiagnosed, managed or not. Sponsorship is primarily aimed at denigrating and controlling newcomers. Many AA sponsors are drawn to this pastime in the absence of fulfilling life purpose, such as employment or a life partner. As recovering alcoholics and long-term AA members, sponsors may be permanently disenfranchised from their families of origin. Thus sponsor/sponsee relationships can become intense, raising long term co-dependence issues. Some sponsors are renowned for breaking up marriages and families, and have made world news in recent years after sexually exploiting vulnerable newcomers (Fisher, M), as any quick internet search will confirm with recent media news reports. (Just Google search “Alcoholics Anonymous accused”.)
Evidence shows that having a sponsor is non-beneficial. Published 2002 findings indicated that having a sponsor in NA/AA was not associated with any improvement in 1-year sustained abstinence rates than a non-sponsored group. However, being a sponsor over the same time period was strongly associated with substantial improvements in sustained abstinence rates for the sponsors. So sponsorship is only to the sponsor’s advantage, not the sponsee’s (Crape, et al.)
One’s sponsor, nevertheless, becomes one’s life-coach and mentor. It’s luck-of the-draw as to just how sane and functional, controlling and unbalanced, knowledgeable or ill advising she or he will turn out to be in the fullness of time. Anecdotal evidence is rife of resentful, compulsive ex-sponsors harassing, even stalking, members who chose to leave AA. Should they later feel the need to return, however, deserters are seen as apostates and are often shunned and demeaned as such, overtly or insidiously.
AA’s working model of alcoholism
Instrumental in popularising the modern disease concept, AA, whose program is constitutionally unchangeable, is culturally entrenched in addressing alcoholism as a disease, whether medical or spiritual. Whilst science has moved on, AA has remained static and at odds with continually developing understandings of addiction. This compromises AA members’ understanding of their diagnoses and prognoses, limiting perceived scope of personal potential, ambition and related motivational incentive. Members resign themselves to being incurably “diseased” for life.
Peele et al, in The Truth about Addiction and Recovery, provide articulate grounds for arguing Why the Disease Model Doesn’t Work— Why It Even Does More Harm than Good in a chapter of that title. Disease model “folklore” is non-factual and “It makes matters worse than they are. It stigmatises people for life. It brutalises and brainwashes the young. It ignores the rest of the person’s problems in favor of blaming them all on the addiction. It traps people in a world inhabited by fellow disease-sufferers.” The disease model is wrong because “People do not necessarily lose control of themselves whenever they are exposed to the object of their addiction. Addiction usually does not last a lifetime. Progression is not inevitable—it is the exception. Treatment is no panacea.”
AA groups apply the disease model to all problem drinkers, whether or not they are ‘full-blown’ alcoholics, demanding abstinence-only where harm-reduction would often be more realistic and compliance more likely. Harm reduction approaches embrace the full range of harm-reducing goals including, but not limited to, abstinence (Tatarsky.) Harm-reduction, however, is heresy to AA, where the distinction between problem drinking and alcohol dependence is rejected. (Australia’s other self-help group option, SMART Recovery, shares the same ideal goal of abstinence while recognising progress through reduced intake). Says Stanton Peele, "If you had an 18-year-old drinking way too much on weekends, would the best approach be to take him to AA and convince him he has a lifelong disease?"
And now the ‘disease’ label is applied not only to alcoholism, drug addiction, cigarette smoking, and overeating, but also to gambling, compulsive shopping, desperate romantic attachments, and even committing rape or killing one’s newborn child! A.A.’s image of ‘powerlessness over alcohol’ is being extended to everything that people feel they are unable to resist or control. (Peele et al 1992.)
Dr. David Rudy’s study of AA, Becoming Alcoholic, explores the organisation’s archaic disease model’s wobbly origins: "Like most of us, physicians make errors. For example, Benjamin Rush, the father of American psychiatry, viewed 'negritude' [having black skin as an African or African American] as a special type of leprosy. Rush also viewed lying, murdering, and minority group dissent as mental illnesses. It is also interesting that Rush is responsible for the first clearly developed modern conception of alcoholism [which he considered a disease]. At various later dates American physicians have viewed drug addiction, hyperactivity, suicide, obesity, crime, violence, political dissent, and child abuse as worthy of disease labels and hence treatment by physicians." (Rudy) (Rush).
Although alcoholism had for centuries been informally tagged a “disease” (usually of a “moral” or “social” nature rather than medical), E Morton Jellinek - with AA collaboration - was the father of the modern disease concept of alcoholism. Operating on a phantom doctorate, Jellinek fraudulently formalised and promoted the disease concept, to de-stigmatise alcoholism and for health insurance purposes. (Roizen, R. 2000.) Jellinek's hypothesis was based on self-report questionnaires prepared and distributed within AA for his 1946 study (Hanson) (Baldwin). Only 158 AA questionnaires were used, 60 of them suspiciously excluded from the findings. Jellinek’s conclusion was based on 98 alcoholics handpicked by Mrs Marty Mann who, besides half-funding the study, was the first woman in AA and author of the Big Book chapter Women Suffer Too (in the second through fourth editions). An upper middle class society debutante with wealthy family connections, Mann’s personal crusade upon achieving AA sobriety was de-stigmatisation of the “drunk” to gain public and financial support for officialising the disease concept.
Based on selected subjects chosen to fit the criteria supporting Mann’s preconceived conclusions, Jellinek’s 1946 study findings have never stood up to scientific scrutiny. University of Toronto Professor Mariana Valverde wrote that a biostatistician of Jellinek’s eminence would have been well aware of the "unscientific status" of the "dubiously scientific data that had been collected by AA members". Valverde noted that the AA questionnaire that was the source for Jellinek's classification only had relevance to "the experience of white, male, middle-class alcoholics in the 1940s." (Valverde.) Herbert Fingarette, former World Health Organisation alcoholism and addiction consultant, wrote “No leading research authorities accept the classic disease concept.” (Fingarette, 1988.) Jellinek would later acknowledge the scientific inadequacy of his idea, having originally seen it as only a starting point for research. He was even asked by Yale University to refute his own findings.
Nevertheless, Marty Mann used her social standing, private education and resulting PR career to become a founder of the National Counsel for Alcoholism (now the NCADD) and so promote the disease concept through Jellinek. She also helped start the Yale School of Alcohol Studies (now at Rutgers) with the same agenda. Many histories of AA make only passing mention of Mann, perhaps because NCA had no formal relationship to AA. However, Mann contributed substantially both to AA's growth and to societal acceptance of the disease concept of alcoholism – she is the high profile historic link between AA and Jellinek’s disease concept.
(NB In denial of its role in Jellinek’s 1946 study findings, impossible without Marty Mann and the 90 AA member questionnaires, AA then distanced itself from the disease concept as much as Jellinek had, officiating a non-committal position. The tenth of AA’s Twelve Traditions, published in the AA Grapevine (coincidentally, in 1946) and accepted by the first International AA Convention in Cleveland 1950, states “Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.” The nature of alcoholism then is an “outside issue” for the world’s largest quit drinking program) (Kurtz.)
By 1956 the American Medical Association voted to define alcoholism as a medically treatable disease, a decision based not on analysis of scientific evidence, but on economic grounds, to enable treating physicians to become eligible for payment from third parties, i.e. insurance companies (AMA) (Hanson). The AMA’s move stirred controversy, but Jellinek justified it by saying that a disease is anything that doctors choose to call a disease. (Jellinek.) Dr. Jeffrey Schaler famously argued that "simply calling alcoholism a disease does not make it one." (Schaler, 1989.)
The UK and other leading E.U. nations have long since abandoned the disease model of alcoholism, as has the World Health Organisation. Australia lags, complacently and unnecessarily, behind; fence-sitting while still half-siding with the USA, where billions stand to be lost should the disease model become formally ousted. In America, AA and its program have a stranglehold on an infinitely larger rehab and treatment industry, maintaining medical insurance approval for AA-based treatment (Twelve Step Facilitation, which basically comprises intensive inpatient indoctrination followed by referral to the outpatient meetings circuit). Coercion into American AA continues when unchallenged, as it does in Australia in the forms of court orders for DUI offences, etc. Tribunal-faced airline pilots, doctors, surgeons and military personnel with alcohol-related breach of conduct charges are permitted to hold onto their licences to practice only under agreement to attend AA. Divorcees in child custody battles similarly endure court-imposed AA attendance. Australia’s recovering Alcohol Disorder patients too sick to work often retain Centrelink sickness and disability support only conditional to a GP’s written assurance that the patient is acting in compliance to a government-recognised care plan (which, according to government recommendations, includes ‘Intensive Referral’ to AA, complete with meeting-secretary signed attendance sheets).
Australians are Intensively Referred to AA with only a “sort of” disease - alcoholism - not a medically listed one. Instead of alcoholism, we now have Alcohol Abuse and Dependency Disorders. Dependencies are either time-limited, or recurrent or chronic. Sufferers fit the diagnostic criteria for between one and five episodes in a lifetime, each episode having a natural history of its own. The studied statistical majority recover from each episode with no form of treatment, some even successfully returning to safe drinking levels, many opting for long term abstinence (not statistically conditional to a lifetime of God and AA Service).
Confirming this more complex picture, in 2010 America’s National Institute on Alcohol Abuse and Alcoholism released findings based on the most sophisticated study yet conducted of drinking histories (NIAAA.) It surveyed more than 43,000 individuals representative of the adult population using questions based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Published in 1994, DSM-IV recognises alcohol dependence by preoccupation with drinking, impaired control over drinking, compulsive drinking, drinking despite physical or psychological problems caused or made worse by drinking, and tolerance and/or withdrawal symptoms.
Among NIAAA’s findings were:
Indeed, for generations, alcohol abusers and their physicians took AA’s tenets to be true for all, with Australia’s more conservative GPs to date as recalcitrant about preserving the AA line as AA is, for those whose medical record includes the notation “recovering alcoholic” (even when misguidedly self-diagnosed under AA influence). Such AA-inspired branding is indelible, following many sober Australians through life and beyond, their medical records perpetually subject to the bureaucratic scrutiny of prospective employers, family and criminal courts, coroners, etc.
New criteria to guide U.S. clinicians in diagnosis and treatment await decisions by the DSM-V committee, expected about 2012, with no such corresponding action indicated by Australian equivalent organisations. However, if a similar snapshot can be presumed for the natural history of Australian alcohol disorders, then clearly the mandatory lifetime commitment to AA is unsuitable and inappropriate for most.
AA’s pseudoscientific description of alcoholism as an “incurable, progressive disease” (Big Book, 3rd ed, p227, by Marty Mann), a lifelong condition of the body, mind and soul (even after suffers become teetotal), is also partly based on the false premise of the alcoholic having been born with, or later developing, a physical allergy to the substance that prevents control of his drinking. Most members have internalised this theory via internal folk lore passed down in meetings and have never read that AA itself later acknowledged, in 1976, "alcoholism is not a true allergy, the experts now inform us.” (AA World Services, 1976.) The introduction to AA’s main text, the Big Book, nevertheless remains unchanged, with Dr. William Silkworth’s note that those unable to moderate their drinking have an allergy, and so AA members to this day accept this medical fallacy without question (Big Book page xxx.) Today’s AA novice will still be indoctrinated with this misinformation by her elders.
Bill Wilson made an arbitrary disclaimer comment about AA’s position of the disease model, when specifically asked about alcoholism as a disease. This was not directed to his fellowship, or put into writing for them, but after addressing the annual meeting of the National Catholic Clergy Conference on Alcoholism in 1961: “We AAs have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Hence, we have always called it an illness or a malady – a far safer term for us to use.” (Kurtz.) Yet despite this, AA’s 1973 & 2008 conference-approved literature categorically stated that "we had the disease of alcoholism." (AAWS 1973 & 2008).
From AA's inception to the present, therefore, most members have believed alcoholism to be a disease (Kurtz.) They still share about their “disease” in 2011 and still consider a lifelong, one-size-fits-all recovery program to be the only solution. Some new millennium AA disease theorists lean towards arguing the genetic predisposition factor - the first population-based study of male twins from the USA found that genetic factors played a role in the development of alcoholism among males (Prescott & Kendler). But the arguments had already been put, in lengthy anticipation of this finding, that a predisposition, although increasing the likelihood of chemical dependency in circumstances involving abusive intake levels, is not in itself is a determinant of chosen human behaviours (Fingarette). Stanton Peele had said “If a gene were found to influence alcoholism, would the same gene cause drug addiction? Would it be related to smoking? Would it also cause compulsive gambling and overeating? If so, this would mean that everyone with any of these addictions has this genetic inheritance. Indeed, given the ubiquity of the problems described, the person without this inheritance would seem to be the notable exception. How could an addiction like smoking be genetic?” The bottom line is that having a genetic predisposition to anything does not guarantee anyone’s substance usage patterns nor render anyone “diseased” (Peele, at al) (Peele, 1986) (Peele, 1990).
Nevertheless, AA members [with decades of abstinence] continue to sit daily in meetings, agonising over and praying away an incurable a disease they simply don’t have, while indoctrinating newcomers to do likewise. This is a permanently entrenched, self-perpetuating, dysfunctional culture of blinkered ignorance, misinformation and madness with no end in sight. Whichever country you are in, “AA is the only way” is black and white absolutism, indoctrinating new members with the same belief system, which states that one can only stay sober with the help of God and AA - thus in a wonderful example of circular logic, sobriety is held to be "proof" of AA's "success". (Orange.) Conform or die is the official line, reinforced by AA’s 1986 12 Concepts for World Service: "We know we have to choose conformity to AA's Twelve Steps and Twelve Traditions or else face dissolution and death." (Alcoholics Anonymous World Services, 1986.)
Instrumental in popularising the modern disease concept, AA, whose program is constitutionally unchangeable, is culturally entrenched in addressing alcoholism as a disease, whether medical or spiritual. Whilst science has moved on, AA has remained static and at odds with continually developing understandings of addiction. This compromises AA members’ understanding of their diagnoses and prognoses, limiting perceived scope of personal potential, ambition and related motivational incentive. Members resign themselves to being incurably “diseased” for life.
Peele et al, in The Truth about Addiction and Recovery, provide articulate grounds for arguing Why the Disease Model Doesn’t Work— Why It Even Does More Harm than Good in a chapter of that title. Disease model “folklore” is non-factual and “It makes matters worse than they are. It stigmatises people for life. It brutalises and brainwashes the young. It ignores the rest of the person’s problems in favor of blaming them all on the addiction. It traps people in a world inhabited by fellow disease-sufferers.” The disease model is wrong because “People do not necessarily lose control of themselves whenever they are exposed to the object of their addiction. Addiction usually does not last a lifetime. Progression is not inevitable—it is the exception. Treatment is no panacea.”
AA groups apply the disease model to all problem drinkers, whether or not they are ‘full-blown’ alcoholics, demanding abstinence-only where harm-reduction would often be more realistic and compliance more likely. Harm reduction approaches embrace the full range of harm-reducing goals including, but not limited to, abstinence (Tatarsky.) Harm-reduction, however, is heresy to AA, where the distinction between problem drinking and alcohol dependence is rejected. (Australia’s other self-help group option, SMART Recovery, shares the same ideal goal of abstinence while recognising progress through reduced intake). Says Stanton Peele, "If you had an 18-year-old drinking way too much on weekends, would the best approach be to take him to AA and convince him he has a lifelong disease?"
And now the ‘disease’ label is applied not only to alcoholism, drug addiction, cigarette smoking, and overeating, but also to gambling, compulsive shopping, desperate romantic attachments, and even committing rape or killing one’s newborn child! A.A.’s image of ‘powerlessness over alcohol’ is being extended to everything that people feel they are unable to resist or control. (Peele et al 1992.)
Dr. David Rudy’s study of AA, Becoming Alcoholic, explores the organisation’s archaic disease model’s wobbly origins: "Like most of us, physicians make errors. For example, Benjamin Rush, the father of American psychiatry, viewed 'negritude' [having black skin as an African or African American] as a special type of leprosy. Rush also viewed lying, murdering, and minority group dissent as mental illnesses. It is also interesting that Rush is responsible for the first clearly developed modern conception of alcoholism [which he considered a disease]. At various later dates American physicians have viewed drug addiction, hyperactivity, suicide, obesity, crime, violence, political dissent, and child abuse as worthy of disease labels and hence treatment by physicians." (Rudy) (Rush).
Although alcoholism had for centuries been informally tagged a “disease” (usually of a “moral” or “social” nature rather than medical), E Morton Jellinek - with AA collaboration - was the father of the modern disease concept of alcoholism. Operating on a phantom doctorate, Jellinek fraudulently formalised and promoted the disease concept, to de-stigmatise alcoholism and for health insurance purposes. (Roizen, R. 2000.) Jellinek's hypothesis was based on self-report questionnaires prepared and distributed within AA for his 1946 study (Hanson) (Baldwin). Only 158 AA questionnaires were used, 60 of them suspiciously excluded from the findings. Jellinek’s conclusion was based on 98 alcoholics handpicked by Mrs Marty Mann who, besides half-funding the study, was the first woman in AA and author of the Big Book chapter Women Suffer Too (in the second through fourth editions). An upper middle class society debutante with wealthy family connections, Mann’s personal crusade upon achieving AA sobriety was de-stigmatisation of the “drunk” to gain public and financial support for officialising the disease concept.
Based on selected subjects chosen to fit the criteria supporting Mann’s preconceived conclusions, Jellinek’s 1946 study findings have never stood up to scientific scrutiny. University of Toronto Professor Mariana Valverde wrote that a biostatistician of Jellinek’s eminence would have been well aware of the "unscientific status" of the "dubiously scientific data that had been collected by AA members". Valverde noted that the AA questionnaire that was the source for Jellinek's classification only had relevance to "the experience of white, male, middle-class alcoholics in the 1940s." (Valverde.) Herbert Fingarette, former World Health Organisation alcoholism and addiction consultant, wrote “No leading research authorities accept the classic disease concept.” (Fingarette, 1988.) Jellinek would later acknowledge the scientific inadequacy of his idea, having originally seen it as only a starting point for research. He was even asked by Yale University to refute his own findings.
Nevertheless, Marty Mann used her social standing, private education and resulting PR career to become a founder of the National Counsel for Alcoholism (now the NCADD) and so promote the disease concept through Jellinek. She also helped start the Yale School of Alcohol Studies (now at Rutgers) with the same agenda. Many histories of AA make only passing mention of Mann, perhaps because NCA had no formal relationship to AA. However, Mann contributed substantially both to AA's growth and to societal acceptance of the disease concept of alcoholism – she is the high profile historic link between AA and Jellinek’s disease concept.
(NB In denial of its role in Jellinek’s 1946 study findings, impossible without Marty Mann and the 90 AA member questionnaires, AA then distanced itself from the disease concept as much as Jellinek had, officiating a non-committal position. The tenth of AA’s Twelve Traditions, published in the AA Grapevine (coincidentally, in 1946) and accepted by the first International AA Convention in Cleveland 1950, states “Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.” The nature of alcoholism then is an “outside issue” for the world’s largest quit drinking program) (Kurtz.)
By 1956 the American Medical Association voted to define alcoholism as a medically treatable disease, a decision based not on analysis of scientific evidence, but on economic grounds, to enable treating physicians to become eligible for payment from third parties, i.e. insurance companies (AMA) (Hanson). The AMA’s move stirred controversy, but Jellinek justified it by saying that a disease is anything that doctors choose to call a disease. (Jellinek.) Dr. Jeffrey Schaler famously argued that "simply calling alcoholism a disease does not make it one." (Schaler, 1989.)
The UK and other leading E.U. nations have long since abandoned the disease model of alcoholism, as has the World Health Organisation. Australia lags, complacently and unnecessarily, behind; fence-sitting while still half-siding with the USA, where billions stand to be lost should the disease model become formally ousted. In America, AA and its program have a stranglehold on an infinitely larger rehab and treatment industry, maintaining medical insurance approval for AA-based treatment (Twelve Step Facilitation, which basically comprises intensive inpatient indoctrination followed by referral to the outpatient meetings circuit). Coercion into American AA continues when unchallenged, as it does in Australia in the forms of court orders for DUI offences, etc. Tribunal-faced airline pilots, doctors, surgeons and military personnel with alcohol-related breach of conduct charges are permitted to hold onto their licences to practice only under agreement to attend AA. Divorcees in child custody battles similarly endure court-imposed AA attendance. Australia’s recovering Alcohol Disorder patients too sick to work often retain Centrelink sickness and disability support only conditional to a GP’s written assurance that the patient is acting in compliance to a government-recognised care plan (which, according to government recommendations, includes ‘Intensive Referral’ to AA, complete with meeting-secretary signed attendance sheets).
Australians are Intensively Referred to AA with only a “sort of” disease - alcoholism - not a medically listed one. Instead of alcoholism, we now have Alcohol Abuse and Dependency Disorders. Dependencies are either time-limited, or recurrent or chronic. Sufferers fit the diagnostic criteria for between one and five episodes in a lifetime, each episode having a natural history of its own. The studied statistical majority recover from each episode with no form of treatment, some even successfully returning to safe drinking levels, many opting for long term abstinence (not statistically conditional to a lifetime of God and AA Service).
Confirming this more complex picture, in 2010 America’s National Institute on Alcohol Abuse and Alcoholism released findings based on the most sophisticated study yet conducted of drinking histories (NIAAA.) It surveyed more than 43,000 individuals representative of the adult population using questions based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Published in 1994, DSM-IV recognises alcohol dependence by preoccupation with drinking, impaired control over drinking, compulsive drinking, drinking despite physical or psychological problems caused or made worse by drinking, and tolerance and/or withdrawal symptoms.
Among NIAAA’s findings were:
- Most persons who develop alcohol dependence have mild to moderate disorder, in which they primarily experience impaired control. For example, they set limits and go over them or find it difficult to quit or cut down. In general, these people do not have severe alcohol-related relationship, health, vocational or legal problems.
- About 70 percent of affected persons have a single episode of less than 4 years. The remainder experience an average of five episodes. Thus, it appears that there are two forms of alcohol dependence: time-limited, and recurrent or chronic.
- Twenty years after onset of alcohol dependence, about three-fourths of individuals are in full recovery; more than half of those who have fully recovered drink at low-risk levels without symptoms of alcohol dependence.
- About 75 percent of persons who recover from alcohol dependence do so without seeking any kind of help, including specialty alcohol (rehab) programs and AA.
Indeed, for generations, alcohol abusers and their physicians took AA’s tenets to be true for all, with Australia’s more conservative GPs to date as recalcitrant about preserving the AA line as AA is, for those whose medical record includes the notation “recovering alcoholic” (even when misguidedly self-diagnosed under AA influence). Such AA-inspired branding is indelible, following many sober Australians through life and beyond, their medical records perpetually subject to the bureaucratic scrutiny of prospective employers, family and criminal courts, coroners, etc.
New criteria to guide U.S. clinicians in diagnosis and treatment await decisions by the DSM-V committee, expected about 2012, with no such corresponding action indicated by Australian equivalent organisations. However, if a similar snapshot can be presumed for the natural history of Australian alcohol disorders, then clearly the mandatory lifetime commitment to AA is unsuitable and inappropriate for most.
AA’s pseudoscientific description of alcoholism as an “incurable, progressive disease” (Big Book, 3rd ed, p227, by Marty Mann), a lifelong condition of the body, mind and soul (even after suffers become teetotal), is also partly based on the false premise of the alcoholic having been born with, or later developing, a physical allergy to the substance that prevents control of his drinking. Most members have internalised this theory via internal folk lore passed down in meetings and have never read that AA itself later acknowledged, in 1976, "alcoholism is not a true allergy, the experts now inform us.” (AA World Services, 1976.) The introduction to AA’s main text, the Big Book, nevertheless remains unchanged, with Dr. William Silkworth’s note that those unable to moderate their drinking have an allergy, and so AA members to this day accept this medical fallacy without question (Big Book page xxx.) Today’s AA novice will still be indoctrinated with this misinformation by her elders.
Bill Wilson made an arbitrary disclaimer comment about AA’s position of the disease model, when specifically asked about alcoholism as a disease. This was not directed to his fellowship, or put into writing for them, but after addressing the annual meeting of the National Catholic Clergy Conference on Alcoholism in 1961: “We AAs have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Hence, we have always called it an illness or a malady – a far safer term for us to use.” (Kurtz.) Yet despite this, AA’s 1973 & 2008 conference-approved literature categorically stated that "we had the disease of alcoholism." (AAWS 1973 & 2008).
From AA's inception to the present, therefore, most members have believed alcoholism to be a disease (Kurtz.) They still share about their “disease” in 2011 and still consider a lifelong, one-size-fits-all recovery program to be the only solution. Some new millennium AA disease theorists lean towards arguing the genetic predisposition factor - the first population-based study of male twins from the USA found that genetic factors played a role in the development of alcoholism among males (Prescott & Kendler). But the arguments had already been put, in lengthy anticipation of this finding, that a predisposition, although increasing the likelihood of chemical dependency in circumstances involving abusive intake levels, is not in itself is a determinant of chosen human behaviours (Fingarette). Stanton Peele had said “If a gene were found to influence alcoholism, would the same gene cause drug addiction? Would it be related to smoking? Would it also cause compulsive gambling and overeating? If so, this would mean that everyone with any of these addictions has this genetic inheritance. Indeed, given the ubiquity of the problems described, the person without this inheritance would seem to be the notable exception. How could an addiction like smoking be genetic?” The bottom line is that having a genetic predisposition to anything does not guarantee anyone’s substance usage patterns nor render anyone “diseased” (Peele, at al) (Peele, 1986) (Peele, 1990).
Nevertheless, AA members [with decades of abstinence] continue to sit daily in meetings, agonising over and praying away an incurable a disease they simply don’t have, while indoctrinating newcomers to do likewise. This is a permanently entrenched, self-perpetuating, dysfunctional culture of blinkered ignorance, misinformation and madness with no end in sight. Whichever country you are in, “AA is the only way” is black and white absolutism, indoctrinating new members with the same belief system, which states that one can only stay sober with the help of God and AA - thus in a wonderful example of circular logic, sobriety is held to be "proof" of AA's "success". (Orange.) Conform or die is the official line, reinforced by AA’s 1986 12 Concepts for World Service: "We know we have to choose conformity to AA's Twelve Steps and Twelve Traditions or else face dissolution and death." (Alcoholics Anonymous World Services, 1986.)
Studies and statistics: re-evaluation of comparisons
Lurking darkly over this whole picture is AA’s notorious 5% effectiveness rate, as calculated from its own Triennial Surveys. The official document comprised longitudinal analysis of a survey period between 1977 and 1989, and was entitled Comments on AA’s Triennual Surveys. Previously kept relatively low-key, the document went viral with the subsequent development of digital media. That 5% itself becomes cancelled out, in some assessments, by the estimated spontaneous remission rate of 5%, leaving AA no more statistically effective than no AA (Harm Reduction Network, 2009.)
There are, in fact, much higher estimates of spontaneous remission, which would move AA’s compared effectiveness to a below zero %. Bankole A. Johnson writes that “Many health conditions resolve themselves through what's known as spontaneous remission -- that is, they improve on their own. In the case of the common cold, for example, nearly everyone gets over the virus without medical intervention. In a 2005 article in the journal Addiction, Deborah A. Dawson and her colleagues calculated a natural recovery rate for alcoholism of 24.4 percent -- that is, over the course of a year, 24.4 percent of the alcoholics studied simply wised up, got sick and tired of being sick and tired, and quit. Without treatment and without meetings.” (Johnson, 2010.)
AA World Services has refrained from producing subsequent versions of comments on its surveys, but was unable to prevent critics from saving and uploading copies, which remain online out of AA World Services’ control. (AA World Services, 1989).
In fact, the 5% rate merely refers to retention – 95% of all newcomers have left before the end of their first year. Of course, AA does not consider its program to have failed for these people. The people have failed the program. While this only speaks for attendance, it has further implications. AA surveyors do not include dropouts in their sobriety statistics, which is a deceptive, if not an outright dishonest practice, as in its 2004 survey which misleadingly concluded that, in North America, 36% had been sober more than ten years (AA World Services, 2004.) On such conclusions, Bankole A. Johnson observes that “these numbers are based only on voluntary self-reports by alcoholics who maintain their ties to AA - not exactly a representative sample. There is little compelling evidence that the AA method works, inside or outside a rehab facility.” (Johnson, 2010.)
This infamous 5% figure is not exclusive to the USA but correlated to Australian AA:
Dr Ron Whitington, Chairman of AA Australia General Service Board, commenting on a survey of more than 100 of Australia’s AA groups, stated in AA Around Australia, Spring Edition, 1994: “Our 1992 Survey showed that only 5% of newcomers to AA are still attending meetings after 12 months. This is a truly terrible statistic. Again we must ask ‘Where does the fault lie?’” (Whittington.)
AA’s 95% dropout group undoubtedly includes Australians mentioned in academic comments like Professor Haber’s at NDARC’s 2010 Symposium, “people are not confident in the treatment that exists” and “alcohol problems still have a terrible stigma about them.” People vote with their feet.
The 2003 Handbook of Alcoholism Treatment Approaches: Effective Alternatives rates AA 38 out of the 48 alcohol treatment methods listed by effectiveness (Hester & Miller.)
If your doctor tried to prescribe an archaic folklore remedy for cancer or diabetes that required you to accept powerlessness and insanity, confess your sins, seek restitution, pray to God and carry the message - or even some obsolete pharmaceutical that was used in 1939 - you would surely report him/her for tribunal investigation and seek out another doctor. Scientific inquiry has progressed enormously since the 1930s. Sceptical AA newcomers inclined to browse online resources will have their suspicions confirmed , e.g. Skeptic’s Dictionary comments: “Neither A.A. nor many other SATs [Substance Abuse Treatments] are based on science, nor do they seem interested in doing any scientific studies which might test whether the treatment they give is effective.” (Carroll)
AA has not only refused to change its sadomasochistic 76 year old religious program since its day of inception, but has continued to reject scientific scrutiny, such as independent randomised longitudinal controlled studies – an intransigence triggering hostile academic accusations of concealment of inefficacy. As already mentioned earlier, this constitutional detachment from scientific findings on alcoholism as “outside issues” is entrenched into AA’s culture via its insular Tenth Tradition, which states that “Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.”
So, AA is not actually interested in alcoholism itself, or even in helping non-AA affiliated alcoholics. AA is interested primarily in its own continuance as a religious fellowship. This observation was made by alcohologists Morris E. Chafetz and Harold W. Demone, Jr. in 1962: “In our opinion AA is really not interested in alcoholics in general, but only as they relate to AA itself.” (Chafetz & Demone.)
Any independent research showing that AA could be improved upon or updated is dismissed by AA, which opts, istead to embrace, multi-million dollar institutional cover-ups concealing AA’s ineffectiveness, the Project MATCH case a prime example (Schaler 1996). Project Match, the biggest and most expensive psychotherapy study ever mounted, taking eight years to design and execute, costing $27 million, was dismissed by the revisionist addiction fraternity because of faulty testing methods, such as sampling bias (Peele, 1997.)
More to the point, a 2005 article in the journal BMC Public Health that reanalysed the data from Project MATCH reported that almost all of the effect of treatment was achieved after attending a single session. In other words, it was the initial decision to try to get better that determined a person's chances of succeeding; what followed made little difference. (Johnson, 2010)
Yet many, including the authors of Australia’s Review of the Evidence, nevertheless cite Project MATCH findings to reason that “cognitive behavioural intervention, motivational enhancement and 12-step facilitation were equally effective in reducing alcohol consumption.” (Proude, et al.)
This Project MATCH “equally effective” argument interprets the same as saying that 12-Step treatment is shown to be “no more effective” than other methods, as noted earlier in this paper, by Australia’s Review of the Evidence admission that: “One Cochrane review undertook to compare AA and other 12-step programs to other psychosocial interventions, (Ferri et al 2006). Their main findings were that no experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches to reduce alcohol dependence or problems.” It’s a half-full, half-empty bottle position. Neither the MATCH nor the Cochrane study show AA to be a superior method, even with all of its shortcomings. Stanton Peele has argued: “NIAAA's willingness to interpret MATCH results to support ideas it could not properly test (in the absence of a nontreatment control group) is disturbing both because it is unscientific and seems to be politically motivated. Moreover, several revisionist commentators on Project MATCH have been attacked by MATCH investigators. MATCH and the NIAAA have embargoed alternative interpretations in order to control these results and spin them to their advantage and that of the alcoholism establishment.” (Peele, 1997.)
Some independent research on AA’s role in recovery from alcoholism has, nevertheless, been achieved despite AA. The Ditman study showed that AA increased the rate of re-arrests for public drunkenness (Ditman et al). The Walsh study showed that AA led to future, more expensive hospitalisations (Walsh et al). The Orford and Edwards study found that just having a doctor speak to alcoholics for a single hour, or “brief intervention”, was just as effective as a whole year of AA-based “treatment” (Orford & Edwards.) Demonstrating effective patient care plans without AA, a 2007 Cochrane systematic review confirmed the effectiveness of brief interventions only (Kaner, et al.)
AA insider Dr George Vaillant, Harvard professor, researcher and member of AA’s board of trustees, combined years of studies and research to publish The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery. Vaillant’s AA-based treatment program had the highest death rate of any treatment studied. His findings showed that AA worked no better than spontaneous remission but had a higher mortality rate, admitting candidly, “not only had we failed to alter the natural history of alcoholism, but our death rate of three percent a year was appalling.” (Vaillant.) AA’s venerable Dr. Vaillant also acknowledged that 60% of recovering alcoholics do so without AA (AA Grapevine, 5/2001.)
According to the NIAAA Spectrum, “The realization dawned gradually as researchers analysed data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). In most persons affected, alcohol dependence (commonly known as alcoholism) looks less like Nicolas Cage in Leaving Las Vegas than it does your party-hardy college roommate or that hard-driving colleague in the next cubicle.” (NIAAA 2010)
In our age of the internet, all of the information collated for this paper is sourced and verified in a click by Australian alcohol disorder sufferers like “your party-hardy college roommate or that hard-driving colleague in the next cubicle” out to research their own recovery options. Can it be any small wonder, then, that NDARC’s 2010 findings show that only 1 in five Australians with alcohol problems seek out treatment and that most are “not confident in the treatment that exists”? Alcoholics who want to address their condition may well understandably fear having the next drink less than a lifetime of AA.
Lurking darkly over this whole picture is AA’s notorious 5% effectiveness rate, as calculated from its own Triennial Surveys. The official document comprised longitudinal analysis of a survey period between 1977 and 1989, and was entitled Comments on AA’s Triennual Surveys. Previously kept relatively low-key, the document went viral with the subsequent development of digital media. That 5% itself becomes cancelled out, in some assessments, by the estimated spontaneous remission rate of 5%, leaving AA no more statistically effective than no AA (Harm Reduction Network, 2009.)
There are, in fact, much higher estimates of spontaneous remission, which would move AA’s compared effectiveness to a below zero %. Bankole A. Johnson writes that “Many health conditions resolve themselves through what's known as spontaneous remission -- that is, they improve on their own. In the case of the common cold, for example, nearly everyone gets over the virus without medical intervention. In a 2005 article in the journal Addiction, Deborah A. Dawson and her colleagues calculated a natural recovery rate for alcoholism of 24.4 percent -- that is, over the course of a year, 24.4 percent of the alcoholics studied simply wised up, got sick and tired of being sick and tired, and quit. Without treatment and without meetings.” (Johnson, 2010.)
AA World Services has refrained from producing subsequent versions of comments on its surveys, but was unable to prevent critics from saving and uploading copies, which remain online out of AA World Services’ control. (AA World Services, 1989).
In fact, the 5% rate merely refers to retention – 95% of all newcomers have left before the end of their first year. Of course, AA does not consider its program to have failed for these people. The people have failed the program. While this only speaks for attendance, it has further implications. AA surveyors do not include dropouts in their sobriety statistics, which is a deceptive, if not an outright dishonest practice, as in its 2004 survey which misleadingly concluded that, in North America, 36% had been sober more than ten years (AA World Services, 2004.) On such conclusions, Bankole A. Johnson observes that “these numbers are based only on voluntary self-reports by alcoholics who maintain their ties to AA - not exactly a representative sample. There is little compelling evidence that the AA method works, inside or outside a rehab facility.” (Johnson, 2010.)
This infamous 5% figure is not exclusive to the USA but correlated to Australian AA:
Dr Ron Whitington, Chairman of AA Australia General Service Board, commenting on a survey of more than 100 of Australia’s AA groups, stated in AA Around Australia, Spring Edition, 1994: “Our 1992 Survey showed that only 5% of newcomers to AA are still attending meetings after 12 months. This is a truly terrible statistic. Again we must ask ‘Where does the fault lie?’” (Whittington.)
AA’s 95% dropout group undoubtedly includes Australians mentioned in academic comments like Professor Haber’s at NDARC’s 2010 Symposium, “people are not confident in the treatment that exists” and “alcohol problems still have a terrible stigma about them.” People vote with their feet.
The 2003 Handbook of Alcoholism Treatment Approaches: Effective Alternatives rates AA 38 out of the 48 alcohol treatment methods listed by effectiveness (Hester & Miller.)
If your doctor tried to prescribe an archaic folklore remedy for cancer or diabetes that required you to accept powerlessness and insanity, confess your sins, seek restitution, pray to God and carry the message - or even some obsolete pharmaceutical that was used in 1939 - you would surely report him/her for tribunal investigation and seek out another doctor. Scientific inquiry has progressed enormously since the 1930s. Sceptical AA newcomers inclined to browse online resources will have their suspicions confirmed , e.g. Skeptic’s Dictionary comments: “Neither A.A. nor many other SATs [Substance Abuse Treatments] are based on science, nor do they seem interested in doing any scientific studies which might test whether the treatment they give is effective.” (Carroll)
AA has not only refused to change its sadomasochistic 76 year old religious program since its day of inception, but has continued to reject scientific scrutiny, such as independent randomised longitudinal controlled studies – an intransigence triggering hostile academic accusations of concealment of inefficacy. As already mentioned earlier, this constitutional detachment from scientific findings on alcoholism as “outside issues” is entrenched into AA’s culture via its insular Tenth Tradition, which states that “Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.”
So, AA is not actually interested in alcoholism itself, or even in helping non-AA affiliated alcoholics. AA is interested primarily in its own continuance as a religious fellowship. This observation was made by alcohologists Morris E. Chafetz and Harold W. Demone, Jr. in 1962: “In our opinion AA is really not interested in alcoholics in general, but only as they relate to AA itself.” (Chafetz & Demone.)
Any independent research showing that AA could be improved upon or updated is dismissed by AA, which opts, istead to embrace, multi-million dollar institutional cover-ups concealing AA’s ineffectiveness, the Project MATCH case a prime example (Schaler 1996). Project Match, the biggest and most expensive psychotherapy study ever mounted, taking eight years to design and execute, costing $27 million, was dismissed by the revisionist addiction fraternity because of faulty testing methods, such as sampling bias (Peele, 1997.)
More to the point, a 2005 article in the journal BMC Public Health that reanalysed the data from Project MATCH reported that almost all of the effect of treatment was achieved after attending a single session. In other words, it was the initial decision to try to get better that determined a person's chances of succeeding; what followed made little difference. (Johnson, 2010)
Yet many, including the authors of Australia’s Review of the Evidence, nevertheless cite Project MATCH findings to reason that “cognitive behavioural intervention, motivational enhancement and 12-step facilitation were equally effective in reducing alcohol consumption.” (Proude, et al.)
This Project MATCH “equally effective” argument interprets the same as saying that 12-Step treatment is shown to be “no more effective” than other methods, as noted earlier in this paper, by Australia’s Review of the Evidence admission that: “One Cochrane review undertook to compare AA and other 12-step programs to other psychosocial interventions, (Ferri et al 2006). Their main findings were that no experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches to reduce alcohol dependence or problems.” It’s a half-full, half-empty bottle position. Neither the MATCH nor the Cochrane study show AA to be a superior method, even with all of its shortcomings. Stanton Peele has argued: “NIAAA's willingness to interpret MATCH results to support ideas it could not properly test (in the absence of a nontreatment control group) is disturbing both because it is unscientific and seems to be politically motivated. Moreover, several revisionist commentators on Project MATCH have been attacked by MATCH investigators. MATCH and the NIAAA have embargoed alternative interpretations in order to control these results and spin them to their advantage and that of the alcoholism establishment.” (Peele, 1997.)
Some independent research on AA’s role in recovery from alcoholism has, nevertheless, been achieved despite AA. The Ditman study showed that AA increased the rate of re-arrests for public drunkenness (Ditman et al). The Walsh study showed that AA led to future, more expensive hospitalisations (Walsh et al). The Orford and Edwards study found that just having a doctor speak to alcoholics for a single hour, or “brief intervention”, was just as effective as a whole year of AA-based “treatment” (Orford & Edwards.) Demonstrating effective patient care plans without AA, a 2007 Cochrane systematic review confirmed the effectiveness of brief interventions only (Kaner, et al.)
AA insider Dr George Vaillant, Harvard professor, researcher and member of AA’s board of trustees, combined years of studies and research to publish The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery. Vaillant’s AA-based treatment program had the highest death rate of any treatment studied. His findings showed that AA worked no better than spontaneous remission but had a higher mortality rate, admitting candidly, “not only had we failed to alter the natural history of alcoholism, but our death rate of three percent a year was appalling.” (Vaillant.) AA’s venerable Dr. Vaillant also acknowledged that 60% of recovering alcoholics do so without AA (AA Grapevine, 5/2001.)
According to the NIAAA Spectrum, “The realization dawned gradually as researchers analysed data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). In most persons affected, alcohol dependence (commonly known as alcoholism) looks less like Nicolas Cage in Leaving Las Vegas than it does your party-hardy college roommate or that hard-driving colleague in the next cubicle.” (NIAAA 2010)
In our age of the internet, all of the information collated for this paper is sourced and verified in a click by Australian alcohol disorder sufferers like “your party-hardy college roommate or that hard-driving colleague in the next cubicle” out to research their own recovery options. Can it be any small wonder, then, that NDARC’s 2010 findings show that only 1 in five Australians with alcohol problems seek out treatment and that most are “not confident in the treatment that exists”? Alcoholics who want to address their condition may well understandably fear having the next drink less than a lifetime of AA.
Common misperceptions of AA’s benignity
In Alcoholics Anonymous, Cult or Cure? Charles Bufe effectively examines how, for 76 years, AA has wormed its way into our judicial, educational & social fabric, yet when asked for results — empirical, verifiable, large-scale results — it responds with a shrug of its shoulders. AA needs to substantiate the credit it so lavishly gives to itself. (Bufe, 1998.) He observes: “AA is far from being the innocent organization that most people believe it to be. The familiar gatherings of coffee-slurping, cigarette-smoking ex-drunks are only the tip of the iceberg. AA and its disease concept of alcoholism dominate the alcoholism treatment field in this country. Through its hidden members and its carefully cultivated benign image, AA has tremendous influence in the media. It has powerful ‘educational’ and ‘medical’ front groups, such as the NCADD and ASAM, that to a great extent determine the direction of alcoholism research, treatment, and education. (...) AA’s front groups and hidden members vilify and blackball critics and independent researchers. AA and 12-step treatment advocates attempt to smother alternative treatment approaches. And AA’s friends and hidden members in EAPs, diversion programs, the judiciary, and penal system coerce probably half-a-million Americans per year into AA attendance and/or 12-step treatment. This comprises AA’s hidden structure and hidden influence.” (Bufe, 1998.)
Whilst Bufe’s commentary paints a pointedly American picture of AA, its institutional influence is proportionally as great if not greater in Australia, where it endures far less competition and is touted by ‘impartial’ academics in government guidelines as “the most widely available program for alcohol-dependent people” and “the prototype for many self-help groups” to “promote increased self-awareness and heighten a sense of meaning in life,” etc. This positive spin borders upon grandstanding in some parts of Australia's guidelines. (Haber et al) (Proude et al) Guidelines 2009 gives AA an ‘A’ recommendation, compared with a ‘D’ for AA’s alternative self-help program, despite listing AA’s ‘evidence rating’ as much lower than its alternative self-help-program’s. Such illogical academic ‘favouritism’ - in print - suggests authorial input by either undisclosed 12-Step promoters, or by parties with no direct 12-Step history, their cockeyed reasoning affected by fraternal influence alone.
Ken Ragge, author of The Real AA: Behind the Myth of 12-Step Recovery, writes more on A.A.'s unofficial front groups: "To keep AA purely spiritual, the membership has what appears to be severe restrictions on efforts to ‘carry the message.’ They can't solicit or accept money from outside sources. They can't ally themselves, as a group, with other organizations. They must, as AA members, remain anonymous in the media. As AA members, they can't take a public stand on any political or social issue. However, there are no restrictions on AA members founding outside organizations allied with AA or moving existing organizations into alliance with AA. As members of outside organizations they are able to solicit funds and take stands on social and political issues. They can also ‘educate the public.’ In fact a ‘not AA’ corporation can do whatever it sees fit to carry the message except use the AA name and identify itself with the public as AA. In a legal, corporate sense, AA doctrine has been spread more by ‘not AA’ organizations and ‘not AA’ people than by AA." (Ragge, 1998)
A comprehensive look at AA’s front groups and societal influence is well presented online at the Addiction Recovery Information Distribution site (ARID).
The ‘AA Front Groups’ commentary is a latter-day extension of the longstanding accusation that AA is a cult. Can referring practitioners safely dismiss this as mere sensationalism, without a second thought on which AA group they direct patients to for extended care?
Steven Mohr, in a thorough and incisive 2009 Free Inquiry article titled Exposing the Myth of Alcoholics Anonymous, characterised AA as a religious cult. (Mohr) “AA is not only a religious cult, it is a radical cult, an evil cult, a widespread cult, and a dangerous cult,” writes Jack Trimpey, one of AA’s more extreme critics, in his much circulated Journal of Rational Recovery article Alcoholics Anonymous: Of Course It’s a Cult! (Trimpey)
Drawing on scores of publications penned since the 1940s about AA as a cult, two notably balanced recent academic contributions were L. Allen Ragels’ Is Alcoholics Anonymous a Cult? An Old Question Revisited and Jeffrey A. Schaler’s Cult-Busting. Both authors found AA to be a cult, having used as a main reference the modern definitive work of its genre, Francesca Alexander and Michele Rollins’ 1984 project, Alcoholics Anonymous: The Unseen Cult. Alexander and Rollins were sociologists who had infiltrated AA under cover to investigate cult practices. They measured AA against criteria developed by Robert J. Lifton. His 1961 book Thought Reform and the Psychology of Totalism, based on his research of the Communist “re-education” programs of Mao Tse-tung, is a classic work on brainwashing. Alexander and Rollins concluded that, “On the basis of this study, the authors contend that AA uses all the methods of brain washing, which are also the methods used by cults. It is our contention that AA is a cult.” (Alexander & Rollins.) They found that AA’s established cult criteria characteristics include sacred science, mystical manipulation, sacred texts, chants and rituals, demand for confession and purity, milieu control, love-bombing and family substitution, loaded language and parallel “thought reform” mind control techniques to those used in Red China.
In The Real AA: Behind the Myth of 12-Step Recovery, author Ken Ragge demonstrates AA’s cult status using a checklist of characteristics from cult exit psychologist Michael Langone’s book Cults: What Parents Should Know (Langone.) Ragge notes that anti-intellectual thought-stopping slogans, such as “utilise, don’t analyse”, “let go and let God” and “keep it simple, stupid” are displayed and chanted, to short-circuit critical thinking. His checklist is also published separately on his More Revealed website, entitled Mind-Manipulating Cults: "Anonymous" Groups Fit the Model (Ragge).
AA apologists have argued, “So what if AA is a cult?” And “There are worse cults,” and “maybe alcoholics need mind-control to recover,” etc. Alexander and Rollins included this point in their cult findings: “The cult offers these alcoholics that which they need: understanding, absolute rules by which to live, and escape from loneliness and social isolation. But for others AA fails, and this failure may be made more acute because AA is today recognized as the most successful tool for coping with alcoholism (...) It is possible that the kind of alcoholic which AA can help is limited to a given psychological type; probably one who can accept the intimacy that AA demands, and one who is willing to lose his individual identity for the identity offered by the group. Apparently AA recognizes this limitation for they stipulate that ‘those who do not recover (from alcoholism) are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves’” (Alexander & Rollins.)
Trice and Roman, too, found in their clinical paper Delabeling, relabeling, and Alcoholics Anonymous a notable AA personality type: "The successful affiliates were more guilt prone, sensitive to responsibility, more serious and introspective ... the affiliates possessed a greater degree of measured ego strength, affiliative needs and group dependency."(Trice & Roman.)
Human rights proponents, however, argue that no form of mind-control is justifiable. Freedom of Mind Centre writers Lama Surya Das and Steve Hassan M.Ed NCC (using Robert J. Lifton’s benchmark standards) elaborate on how mind control techniques can be used to destroy individuality, stunt personal growth and create virtual slaves, as exemplified by Adolf Hitler. People can be deceptively manipulated and indoctrinated to distrust their ability to feel, to think, and to make mature decisions (Das, S, & Hassan,S.) The FOMC is dedicated to respect for human rights, spirituality and consumer awareness.
Tossing a spanner into this debate, Hassan, acclaimed cult exit counsellor, author and creator of the BITE cult assessment model, has categorically stated that his freedom of Mind Centre does not consider AA to fit his BITE cult model. He agrees, nevertheless, that AA is not suitable for all people, is potentially destructive for some members and that alternative programs may be more beneficial. He therefore lists AA on his site with the disclaimer: “We are of the opinion that AA has helped many individuals in their fight against alcoholism, but we include this group because we believe there are other points of view; vital information and experiences that should be shared. And we certainly do NOT think that AA fits the BITE mind control model” (Hassan.) The BITE model was established in his 2000 publication Releasing the Bonds: Empowering People to Think for Themselves.
Devin Sexson followed Hassan’s refute of AA’s full cult criteria with the 2002 paper, Mind Control Tactics of Alcoholics Anonymous, disputing Hassan’s negative assessment and reusing Hassan’s own BITE model to demonstrate AA’s cult criteria. Sexson calls AA a “cult of necrophilia” (Sexson.)
Charles Bufe, in his book Alcoholics Anonymous, Cult or Cure, disagrees that, in general, “group-level AA” automatically constitutes cult practice. Instead he demonstrates “institutional AA” as rife in cultic ways, with powerful hidden members unethically wielding influence in government, law and medicine (Bufe, 1998).
Such inconclusive academic debate, whilst insightful, cannot provide sound assurance either way for the potential AA consumer or their referring professional. It is impossible to predetermine how any local chapter of AA will measure up in cult characteristics, or how static or changing any one group’s personal dynamics will be, affecting how cultic each group is or is not at various periods. There are no wider control measures than those applied by each autonomous group in its AA-prescribed “Group Conscience” and this is expressed only through God, as per AA’s official 2nd and 4th Traditions. Tradition 2: “For our group purpose there is but one ultimate authority - a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.” Tradition 4: “Each group should be autonomous except in matters affecting other groups or A.A. as a whole.” Depending upon which personality currently heads the group’s unofficial pecking order, the “principles before personalities” guideline of Tradition 12 may be open to interpretation (AA World Services Inc., 1986.)
AA’s headquarter divisions disown reports of bad AA, suing members who tread on its toes. For example, in 1998 AA sued a German member of 18 years, placing him in financial ruin for distributing free AA books which he had translated into his native tongue and paid to have printed, to carry AA’s message to still suffering alcoholics, in the absence of any such product available from Alcoholics Anonymous World Services, Inc. This legal action was taken by AAeV in Germany and endorsed by the General Service Board of Trustees of AAWS Inc. (K, Mitchel.)
Showing the other side of the coin, however, in May 2007 American Newsweek ran a three part report by Nick Summers, profiling an AA group in Washington DC accused of cult-like and abusive behaviour. Midtown members pressured a recent attendee, a teenage girl, to cut off ties with anyone outside the group, to stop taking doctor-prescribed medications for her bipolar disorder, and to become sexually involved with other group members. “Kathy” was 17 and the group leader was 56. She said that members told her to engage in sex with him because it would increase her chances of being sober, and that she would be more accepted in the group. Newer group members were also pressured to do chores for more established group members, as though they were pledging for a fraternity (Summers.) In subsequent related news articles, officials from the prominent church where the group met announced they had barred AA from meeting there, pending investigation (Fisher.) AA World Services did not move to have that meeting delisted and offered no media comment other than to point out the group’s autonomy. This news went viral on the internet, drawing the world’s attention to similar news reports of AA groups citing different cases (just Google “Alcoholics Anonymous sexual harassment” for 3,520 results / “Alcoholics Anonymous cult” 360,000 results).
In Alcoholics Anonymous, Cult or Cure? Charles Bufe effectively examines how, for 76 years, AA has wormed its way into our judicial, educational & social fabric, yet when asked for results — empirical, verifiable, large-scale results — it responds with a shrug of its shoulders. AA needs to substantiate the credit it so lavishly gives to itself. (Bufe, 1998.) He observes: “AA is far from being the innocent organization that most people believe it to be. The familiar gatherings of coffee-slurping, cigarette-smoking ex-drunks are only the tip of the iceberg. AA and its disease concept of alcoholism dominate the alcoholism treatment field in this country. Through its hidden members and its carefully cultivated benign image, AA has tremendous influence in the media. It has powerful ‘educational’ and ‘medical’ front groups, such as the NCADD and ASAM, that to a great extent determine the direction of alcoholism research, treatment, and education. (...) AA’s front groups and hidden members vilify and blackball critics and independent researchers. AA and 12-step treatment advocates attempt to smother alternative treatment approaches. And AA’s friends and hidden members in EAPs, diversion programs, the judiciary, and penal system coerce probably half-a-million Americans per year into AA attendance and/or 12-step treatment. This comprises AA’s hidden structure and hidden influence.” (Bufe, 1998.)
Whilst Bufe’s commentary paints a pointedly American picture of AA, its institutional influence is proportionally as great if not greater in Australia, where it endures far less competition and is touted by ‘impartial’ academics in government guidelines as “the most widely available program for alcohol-dependent people” and “the prototype for many self-help groups” to “promote increased self-awareness and heighten a sense of meaning in life,” etc. This positive spin borders upon grandstanding in some parts of Australia's guidelines. (Haber et al) (Proude et al) Guidelines 2009 gives AA an ‘A’ recommendation, compared with a ‘D’ for AA’s alternative self-help program, despite listing AA’s ‘evidence rating’ as much lower than its alternative self-help-program’s. Such illogical academic ‘favouritism’ - in print - suggests authorial input by either undisclosed 12-Step promoters, or by parties with no direct 12-Step history, their cockeyed reasoning affected by fraternal influence alone.
Ken Ragge, author of The Real AA: Behind the Myth of 12-Step Recovery, writes more on A.A.'s unofficial front groups: "To keep AA purely spiritual, the membership has what appears to be severe restrictions on efforts to ‘carry the message.’ They can't solicit or accept money from outside sources. They can't ally themselves, as a group, with other organizations. They must, as AA members, remain anonymous in the media. As AA members, they can't take a public stand on any political or social issue. However, there are no restrictions on AA members founding outside organizations allied with AA or moving existing organizations into alliance with AA. As members of outside organizations they are able to solicit funds and take stands on social and political issues. They can also ‘educate the public.’ In fact a ‘not AA’ corporation can do whatever it sees fit to carry the message except use the AA name and identify itself with the public as AA. In a legal, corporate sense, AA doctrine has been spread more by ‘not AA’ organizations and ‘not AA’ people than by AA." (Ragge, 1998)
A comprehensive look at AA’s front groups and societal influence is well presented online at the Addiction Recovery Information Distribution site (ARID).
The ‘AA Front Groups’ commentary is a latter-day extension of the longstanding accusation that AA is a cult. Can referring practitioners safely dismiss this as mere sensationalism, without a second thought on which AA group they direct patients to for extended care?
Steven Mohr, in a thorough and incisive 2009 Free Inquiry article titled Exposing the Myth of Alcoholics Anonymous, characterised AA as a religious cult. (Mohr) “AA is not only a religious cult, it is a radical cult, an evil cult, a widespread cult, and a dangerous cult,” writes Jack Trimpey, one of AA’s more extreme critics, in his much circulated Journal of Rational Recovery article Alcoholics Anonymous: Of Course It’s a Cult! (Trimpey)
Drawing on scores of publications penned since the 1940s about AA as a cult, two notably balanced recent academic contributions were L. Allen Ragels’ Is Alcoholics Anonymous a Cult? An Old Question Revisited and Jeffrey A. Schaler’s Cult-Busting. Both authors found AA to be a cult, having used as a main reference the modern definitive work of its genre, Francesca Alexander and Michele Rollins’ 1984 project, Alcoholics Anonymous: The Unseen Cult. Alexander and Rollins were sociologists who had infiltrated AA under cover to investigate cult practices. They measured AA against criteria developed by Robert J. Lifton. His 1961 book Thought Reform and the Psychology of Totalism, based on his research of the Communist “re-education” programs of Mao Tse-tung, is a classic work on brainwashing. Alexander and Rollins concluded that, “On the basis of this study, the authors contend that AA uses all the methods of brain washing, which are also the methods used by cults. It is our contention that AA is a cult.” (Alexander & Rollins.) They found that AA’s established cult criteria characteristics include sacred science, mystical manipulation, sacred texts, chants and rituals, demand for confession and purity, milieu control, love-bombing and family substitution, loaded language and parallel “thought reform” mind control techniques to those used in Red China.
In The Real AA: Behind the Myth of 12-Step Recovery, author Ken Ragge demonstrates AA’s cult status using a checklist of characteristics from cult exit psychologist Michael Langone’s book Cults: What Parents Should Know (Langone.) Ragge notes that anti-intellectual thought-stopping slogans, such as “utilise, don’t analyse”, “let go and let God” and “keep it simple, stupid” are displayed and chanted, to short-circuit critical thinking. His checklist is also published separately on his More Revealed website, entitled Mind-Manipulating Cults: "Anonymous" Groups Fit the Model (Ragge).
AA apologists have argued, “So what if AA is a cult?” And “There are worse cults,” and “maybe alcoholics need mind-control to recover,” etc. Alexander and Rollins included this point in their cult findings: “The cult offers these alcoholics that which they need: understanding, absolute rules by which to live, and escape from loneliness and social isolation. But for others AA fails, and this failure may be made more acute because AA is today recognized as the most successful tool for coping with alcoholism (...) It is possible that the kind of alcoholic which AA can help is limited to a given psychological type; probably one who can accept the intimacy that AA demands, and one who is willing to lose his individual identity for the identity offered by the group. Apparently AA recognizes this limitation for they stipulate that ‘those who do not recover (from alcoholism) are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves’” (Alexander & Rollins.)
Trice and Roman, too, found in their clinical paper Delabeling, relabeling, and Alcoholics Anonymous a notable AA personality type: "The successful affiliates were more guilt prone, sensitive to responsibility, more serious and introspective ... the affiliates possessed a greater degree of measured ego strength, affiliative needs and group dependency."(Trice & Roman.)
Human rights proponents, however, argue that no form of mind-control is justifiable. Freedom of Mind Centre writers Lama Surya Das and Steve Hassan M.Ed NCC (using Robert J. Lifton’s benchmark standards) elaborate on how mind control techniques can be used to destroy individuality, stunt personal growth and create virtual slaves, as exemplified by Adolf Hitler. People can be deceptively manipulated and indoctrinated to distrust their ability to feel, to think, and to make mature decisions (Das, S, & Hassan,S.) The FOMC is dedicated to respect for human rights, spirituality and consumer awareness.
Tossing a spanner into this debate, Hassan, acclaimed cult exit counsellor, author and creator of the BITE cult assessment model, has categorically stated that his freedom of Mind Centre does not consider AA to fit his BITE cult model. He agrees, nevertheless, that AA is not suitable for all people, is potentially destructive for some members and that alternative programs may be more beneficial. He therefore lists AA on his site with the disclaimer: “We are of the opinion that AA has helped many individuals in their fight against alcoholism, but we include this group because we believe there are other points of view; vital information and experiences that should be shared. And we certainly do NOT think that AA fits the BITE mind control model” (Hassan.) The BITE model was established in his 2000 publication Releasing the Bonds: Empowering People to Think for Themselves.
Devin Sexson followed Hassan’s refute of AA’s full cult criteria with the 2002 paper, Mind Control Tactics of Alcoholics Anonymous, disputing Hassan’s negative assessment and reusing Hassan’s own BITE model to demonstrate AA’s cult criteria. Sexson calls AA a “cult of necrophilia” (Sexson.)
Charles Bufe, in his book Alcoholics Anonymous, Cult or Cure, disagrees that, in general, “group-level AA” automatically constitutes cult practice. Instead he demonstrates “institutional AA” as rife in cultic ways, with powerful hidden members unethically wielding influence in government, law and medicine (Bufe, 1998).
Such inconclusive academic debate, whilst insightful, cannot provide sound assurance either way for the potential AA consumer or their referring professional. It is impossible to predetermine how any local chapter of AA will measure up in cult characteristics, or how static or changing any one group’s personal dynamics will be, affecting how cultic each group is or is not at various periods. There are no wider control measures than those applied by each autonomous group in its AA-prescribed “Group Conscience” and this is expressed only through God, as per AA’s official 2nd and 4th Traditions. Tradition 2: “For our group purpose there is but one ultimate authority - a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.” Tradition 4: “Each group should be autonomous except in matters affecting other groups or A.A. as a whole.” Depending upon which personality currently heads the group’s unofficial pecking order, the “principles before personalities” guideline of Tradition 12 may be open to interpretation (AA World Services Inc., 1986.)
AA’s headquarter divisions disown reports of bad AA, suing members who tread on its toes. For example, in 1998 AA sued a German member of 18 years, placing him in financial ruin for distributing free AA books which he had translated into his native tongue and paid to have printed, to carry AA’s message to still suffering alcoholics, in the absence of any such product available from Alcoholics Anonymous World Services, Inc. This legal action was taken by AAeV in Germany and endorsed by the General Service Board of Trustees of AAWS Inc. (K, Mitchel.)
Showing the other side of the coin, however, in May 2007 American Newsweek ran a three part report by Nick Summers, profiling an AA group in Washington DC accused of cult-like and abusive behaviour. Midtown members pressured a recent attendee, a teenage girl, to cut off ties with anyone outside the group, to stop taking doctor-prescribed medications for her bipolar disorder, and to become sexually involved with other group members. “Kathy” was 17 and the group leader was 56. She said that members told her to engage in sex with him because it would increase her chances of being sober, and that she would be more accepted in the group. Newer group members were also pressured to do chores for more established group members, as though they were pledging for a fraternity (Summers.) In subsequent related news articles, officials from the prominent church where the group met announced they had barred AA from meeting there, pending investigation (Fisher.) AA World Services did not move to have that meeting delisted and offered no media comment other than to point out the group’s autonomy. This news went viral on the internet, drawing the world’s attention to similar news reports of AA groups citing different cases (just Google “Alcoholics Anonymous sexual harassment” for 3,520 results / “Alcoholics Anonymous cult” 360,000 results).
Bureaucratic buck-passing and patient coercion
Government generated medical guidelines and reviews for alcohol abuse disorders need to be accurate and honestly informed. Implied refute of AA’s necessary religiosity while advising Intensive Referral is bordering on government-coerced religion in denial. It can effectively result in passive medical malpractice on the part of the referring practitioner, who is trained, paid and obligated under Hippocratic Oath to “Intensively Refer” to medicine, not theology (Toth.) But then as long as the medical and related governmental fraternities maintain a knowledgeable ignorance on the matter, none can be blamed for “knowing” what adverse effects misguided intensive AA referral might have on a patient’s life.
Australia’s Review of the Evidence advises, “Timko et al. (2006; see also Timko and DeBenedetti, 2007) have demonstrated that therapists’ referral practices influence the depth of the client’s participation in AA. Intensive referral (IR) practices include providing meeting schedule and public transport timetables, finding a temporary sponsor and organising for AA volunteers to accompany the client to meetings, and asking the client to use a ‘meeting journal’ (signed off by the AA meeting convener) to record attendance and reactions to the meeting.”
Requiring signed proof of attendance undermines trust in any professional therapeutic relationship. Not only are elements of Intensive Referral coercive, but some of its supposed positive outcomes are of simply no evidence-based value. For example, having a sponsor has been clinically demonstrated to be no more effective than not having one: Crape, et al found that “having a sponsor in NA/AA for this population was not associated with any improvement in 1-year sustained abstinence rates than a non-sponsored group.” (Crape, et al.)
Where is the logic in arguing for such thinly veiled coercion into a religious movement that all parties admit is not even a treatment, nor proven to be a superior self-help option, and that others have clinically demonstrated to be harmful?
The government’s authors leave a wide berth for themselves, the government, our referring practitioners and AA, by inclusion of disclaimer-like content such as “although not intrinsically a form of treatment” in the 2009 Guidelines, and that found in a previous (2003) Guidelines for the same government, by NDARC: “Since AA is not viewed as a treatment it is not a sufficient intervention for alcohol problems. As noted earlier AA does not see itself as a treatment, and it fully acknowledges the need for drinkers to access professional assistance when required.” (Shand, et al 2003.) Ironically, “Accessing professional treatment when required” often merely takes a significant portion of alcohol disorder sufferers full circle, resulting in Intensive Referral back to AA.
There is a disproportionate void of Australian AA alternatives (approx 50 SMART Recovery groups to approx 1700 AA groups). There is also a notable absence of available, affordable AA exit counselling for Australians for whom AA has become an unhealthy, empty dependency. This overlooked group struggles to terminate long-term address of AA’s non-existent incurable lifelong disease, and to address the accompanying AA-induced moral guilt, religious fear and social stigma they have become burdened with. If the Australian Federal Government advises Intensive AA Referral by Medicare paid GPs, it ought surely to endorse Medicare subsidised AA exit counselling for those with related progressive psychological issues – a process often compared with defecting from an absolutist regime, cult or orthodox religious internship. But might it not make sense for Australian practitioners to deliberate at greater length before Intensive Referral to AA? Why prescribe a life sentence of superstitious dogma locked within a cultural separatism that has wrecked many erstwhile stable marriage and family (is that really extended “care”?), when a few months of evidence-based secular alternative, followed by infrequent drop-ins, can be effective?
U.S. harm reduction agencies have circulated memos to GPs nationwide alerting them of the potential harm AA can do to the wrong type of alcohol abuser (Harm Reduction Network). One self-help body has bypassed the fraternity, publishing its own free online PDF download consumer kit, AA: Why You Might Want To Look For Another Way. (The Alcoholism Guide.)
Less so in Australia, where professional boundaries are better respected. But when all three parties, the government, its advisory team and authors, and referring practitioners collectively point most alcohol disorder sufferers towards AA, perhaps relieved to have such troubled, often troublesome and troubling patients out of the way, by seemingly looking no deeper into what AA actually is, this fraternity buries its head in the sand.
Government generated medical guidelines and reviews for alcohol abuse disorders need to be accurate and honestly informed. Implied refute of AA’s necessary religiosity while advising Intensive Referral is bordering on government-coerced religion in denial. It can effectively result in passive medical malpractice on the part of the referring practitioner, who is trained, paid and obligated under Hippocratic Oath to “Intensively Refer” to medicine, not theology (Toth.) But then as long as the medical and related governmental fraternities maintain a knowledgeable ignorance on the matter, none can be blamed for “knowing” what adverse effects misguided intensive AA referral might have on a patient’s life.
Australia’s Review of the Evidence advises, “Timko et al. (2006; see also Timko and DeBenedetti, 2007) have demonstrated that therapists’ referral practices influence the depth of the client’s participation in AA. Intensive referral (IR) practices include providing meeting schedule and public transport timetables, finding a temporary sponsor and organising for AA volunteers to accompany the client to meetings, and asking the client to use a ‘meeting journal’ (signed off by the AA meeting convener) to record attendance and reactions to the meeting.”
Requiring signed proof of attendance undermines trust in any professional therapeutic relationship. Not only are elements of Intensive Referral coercive, but some of its supposed positive outcomes are of simply no evidence-based value. For example, having a sponsor has been clinically demonstrated to be no more effective than not having one: Crape, et al found that “having a sponsor in NA/AA for this population was not associated with any improvement in 1-year sustained abstinence rates than a non-sponsored group.” (Crape, et al.)
Where is the logic in arguing for such thinly veiled coercion into a religious movement that all parties admit is not even a treatment, nor proven to be a superior self-help option, and that others have clinically demonstrated to be harmful?
The government’s authors leave a wide berth for themselves, the government, our referring practitioners and AA, by inclusion of disclaimer-like content such as “although not intrinsically a form of treatment” in the 2009 Guidelines, and that found in a previous (2003) Guidelines for the same government, by NDARC: “Since AA is not viewed as a treatment it is not a sufficient intervention for alcohol problems. As noted earlier AA does not see itself as a treatment, and it fully acknowledges the need for drinkers to access professional assistance when required.” (Shand, et al 2003.) Ironically, “Accessing professional treatment when required” often merely takes a significant portion of alcohol disorder sufferers full circle, resulting in Intensive Referral back to AA.
There is a disproportionate void of Australian AA alternatives (approx 50 SMART Recovery groups to approx 1700 AA groups). There is also a notable absence of available, affordable AA exit counselling for Australians for whom AA has become an unhealthy, empty dependency. This overlooked group struggles to terminate long-term address of AA’s non-existent incurable lifelong disease, and to address the accompanying AA-induced moral guilt, religious fear and social stigma they have become burdened with. If the Australian Federal Government advises Intensive AA Referral by Medicare paid GPs, it ought surely to endorse Medicare subsidised AA exit counselling for those with related progressive psychological issues – a process often compared with defecting from an absolutist regime, cult or orthodox religious internship. But might it not make sense for Australian practitioners to deliberate at greater length before Intensive Referral to AA? Why prescribe a life sentence of superstitious dogma locked within a cultural separatism that has wrecked many erstwhile stable marriage and family (is that really extended “care”?), when a few months of evidence-based secular alternative, followed by infrequent drop-ins, can be effective?
U.S. harm reduction agencies have circulated memos to GPs nationwide alerting them of the potential harm AA can do to the wrong type of alcohol abuser (Harm Reduction Network). One self-help body has bypassed the fraternity, publishing its own free online PDF download consumer kit, AA: Why You Might Want To Look For Another Way. (The Alcoholism Guide.)
Less so in Australia, where professional boundaries are better respected. But when all three parties, the government, its advisory team and authors, and referring practitioners collectively point most alcohol disorder sufferers towards AA, perhaps relieved to have such troubled, often troublesome and troubling patients out of the way, by seemingly looking no deeper into what AA actually is, this fraternity buries its head in the sand.
References
(NB: AA historian/members sign authorship in adherence to AA’s Traditions 11 & 12 of anonymity, providing only forename and initial of surname e.g. “Jim F, Grateful Sober Alcoholic” or “Mitchell K.” These are referenced in standard alphabetical order of surname initial, e.g. “Jim F” is listed as “F, Jim” and “Mitchel K” as K, Mitchel)
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NCC